Regional gastrointestinal transit times in patients with chronic pancreatitis.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
14 Oct 2022
14 Oct 2022
Historique:
entrez:
18
10
2022
pubmed:
19
10
2022
medline:
20
10
2022
Statut:
ppublish
Résumé
The mechanisms behind disrupted gastrointestinal (GI) motor function in patients with chronic pancreatitis (CP) have not been fully elucidated. We compared regional transit times in patients with CP to those in healthy controls, and investigated whether they were associated with diabetes mellitus, exocrine dysfunction, opioid treatment or quality of life. Twenty-eight patients with CP and 28 age- and gender-matched healthy controls were included. Regional GI transit times were determined using the 3D-Transit system, which consists of an ingestible electromagnetic capsule and a detector worn in an abdominal belt for 5 days. Exocrine function was assessed using the fecal elastase-1 test, and quality of life was assessed using the European Organization for Research and Treatment of Cancer questionnaire. Transit times were analyzed for associations with diabetes mellitus, exocrine pancreatic insufficiency (EPI), opioid treatment and quality of life. Compared with healthy controls, patients with CP had prolonged transit times in the small intestine (6.6 ± 1.8 vs 4.8 ± 2.2 hours, P = .006), colon (40 ± 23 vs 28 ± 26 hours, P = .02), and total GI tract (52 ± 26 vs 36 ± 26 hours, P = .02). There was no difference in gastric emptying time (4.8 ± 5.2 vs 3.1 ± 1.3 hours, P = .9). No associations between transit times and diabetes, EPI, or opioid consumption were found (all P > .05). Quality of life and associated functional and symptom subscales were not associated with transit times, except for diarrhea (P = .03). Patients with CP have prolonged small intestinal and colonic transit times. However, these alterations do not seem to be mediated by diabetes, EPI, or opioid consumption.
Identifiants
pubmed: 36253998
doi: 10.1097/MD.0000000000031141
pii: 00005792-202210140-00030
pmc: PMC9575730
doi:
Substances chimiques
Analgesics, Opioid
0
Pancreatic Elastase
EC 3.4.21.36
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e31141Informations de copyright
Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Whitcomb DC, Frulloni L, Garg P, et al. Chronic pancreatitis: an international draft consensus proposal for a new mechanistic definition. Pancreatology. 2016;16:218–24.
Chen L, Yu B, Luo D, et al. Enteric motor dysfunctions in experimental chronic pancreatitis: alterations of myenteric neurons regulating colonic motility in rats. Neurogastroenterol Motil. 2018;30:e13301.
Brock C, Olesen SS, Olesen AE, et al. Opioid-induced bowel dysfunction. Drugs. 2012;72:1847–65.
Rosa-e-Silva L, Troncon LEA, Gallo L, et al. Factors associated with abnormal gastric emptying in alcohol-related chronic pancreatitis. J Clin Gastroenterol. 2007;41:306–11.
Nordgaard I, Rumessen JJ, Gudmand-Høsyer E. Assimilation of wheat starch in patients with chronic pancreatitis positive effect of enzyme replacement. Scand J Gastroenterol. 1992;27:412–6.
Janssen P, Vanden Berghe P, Verschueren S, et al. Review article: the role of gastric motility in the control of food intake. Aliment Pharmacol Ther. 2011;33:880–94.
Rosa-e-Silva L, Troncon LEA, Gallo L, et al. Determinants of accelerated small intestinal transit in alcohol-related chronic pancreatitis. Dig Dis Sci. 2010;55:1017–25.
Mizushima T, Ochi K, Ichimura M, et al. Pancreatic enzyme supplement improves dysmotility in chronic pancreatitis patients. J Gastroenterol Hepatol. 2004;19:1005–9.
Long WB, Weiss JB. Rapid gastric emptying of fatty meals in pancreatic insufficiency. Gastroenterology. 1974;67:920–5.
Pieramico O, Dominguez-Muñoz JE, Nelson DK, et al. Interdigestive cycling in chronic pancreatitis: altered coordination among pancreatic secretion, motility, and hormones. Gastroenterology. 1995;109:224–30.
Vu MK, Vecht J, Eddes EH, et al. Antroduodenal motility in chronic pancreatitis: are abnormalities related to exocrine insufficiency? Am J Physiol Liver Physiol. 2000;278:G458–66.
Capurso G, Signoretti M, Archibugi L, et al. Systematic review and meta-analysis: small intestinal bacterial overgrowth in chronic pancreatitis. United Eur Gastroenterol J. 2016;4:697–705.
Haase AM, Gregersen T, Schlageter V, et al. Pilot study trialling a new ambulatory method for the clinical assessment of regional gastrointestinal transit using multiple electromagnetic capsules. Neurogastroenterol Motil. 2014;26:1783–91.
Lankisch PG, Breuer N, Bruns A, et al. Natural history of acute pancreatitis: a long-term population-based study. Am J Gastroenterol. 2009;104:2797–805; quiz 2806.
Nøjgaard C, Olesen SS, Frøkjær JB, et al. Update of exocrine functional diagnostics in chronic pancreatitis. Clin Physiol Funct Imaging. 2013;33:167–72.
Brinck CE, Mark EB, Klinge MW, et al. Magnetic tracking of gastrointestinal motility. Physiol Meas. 2020;41:12TR01.
Aaronson NK, Ahmedzai S, Bergman B, et al. The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.
Nandhra GK, Mark EB, Di Tanna GL, et al. Normative values for region-specific colonic and gastrointestinal transit times in 111 healthy volunteers using the 3D-Transit electromagnet tracking system: Influence of age, gender, and body mass index. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2020;32:e13734.
Jain NK, Boivin M, Zinsmeister AR, et al. Effect of ileal perfusion of carbohydrates and amylase inhibitor on gastrointestinal hormones and emptying. Gastroenterology. 1989;96:377–87.
Layer P, Peschel S, Schlesinger T, et al. Human pancreatic secretion and intestinal motility: effects of ileal nutrient perfusion. Am J Physiol Liver Physiol. 1990;258:G196–201.
Spiller RC, Trotman IF, Adrian TE, et al. Further characterisation of the “ileal brake” reflex in man--effect of ileal infusion of partial digests of fat, protein, and starch on jejunal motility and release of neurotensin, enteroglucagon, and peptide YY. Gut. 1988;29:1042–51.
Lin Z, Liu Y, Zheng Q, et al. Increased proportion of nitric oxide synthase immunoreactive neurons in rat ileal myenteric ganglia after severe acute pancreatitis. BMC Gastroenterol. 2011;11:127.
Bruen CM, O’Halloran F, Cashman KD, et al. The effects of food components on hormonal signalling in gastrointestinal enteroendocrine cells. Food Funct. 2012;3:11311131.
Grønlund D, Poulsen JL, Sandberg TH, et al. Established and emerging methods for assessment of small and large intestinal motility. Neurogastroenterol Motil. 2017;29:e13008.
Hasler WL. The physiology of gastric motility and gastric emptying. Yamada T, ed. In: Textbook of gastroenterology, Fifth Edition. Vol 1. Wiley Online Library: Blackwell Publishing Ltd. 2009:207–230.
Karlsen S, Fynne L, Grønbæk H, et al. Small intestinal transit in patients with liver cirrhosis and portal hypertension: a descriptive study. BMC Gastroenterol. 2012;12:176.
Farmer AD, Drewes AM, Chiarioni G, et al. Pathophysiology and management of opioid-induced constipation: European expert consensus statement. United Eur Gastroenterol J. 2019;7:7–20.
Mark EB, Klinge MW, Grønlund D, et al. Ambulatory assessment of colonic motility using the electromagnetic capsule tracking system: effect of opioids. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2020;32:e13753.
Mark EB, Nedergaard RB, Hansen TM, et al. Tapentadol results in less deterioration of gastrointestinal function and symptoms than standard opioid therapy in healthy male volunteers. Neurogastroenterol Motil Off J Eur Gastrointest Motil Soc. 2021;33:e14131.
Olesen SS, Nøjgaard C, Novovic S, et al. Pain and aetiological risk factors determine quality of life in patients with chronic pancreatitis, but a brick in the puzzle is missing. Pancreatology. 2020;20:1347–53.
Brubaker L, Luu S, Hoffman K, et al. Microbiome changes associated with acute and chronic pancreatitis: a systematic review. Pancreatology. 2021;21:1–14.
Frost F, Weiss FU, Sendler M, et al. The gut microbiome in patients with chronic pancreatitis is characterized by significant dysbiosis and overgrowth by opportunistic pathogens. Clin Transl Gastroenterol. 2020;11:e00232.
Rasmussen HH, Irtun O, Olesen SS, et al. Nutrition in chronic pancreatitis. World J Gastroenterol. 2013;19:7267–75.
Gaskell SK, Rauch CE, Costa RJS. Gastrointestinal assessment and therapeutic intervention for the management of exercise-associated gastrointestinal symptoms: a case series translational and professional practice approach. Front Physiol. 2021;12:719142.
Worsøe J, Fynne L, Gregersen T, et al. Gastric transit and small intestinal transit time and motility assessed by a magnet tracking system. BMC Gastroenterol. 2011;11:145.
Hinton JM, Lennard-Jones JE, Young AC. A new method for studying gut transit times using radioopaque markers. Gut. 1969;10:842–7.
Farmer AD, Scott SM, Hobson AR. Gastrointestinal motility revisited: the wireless motility capsule. United Eur Gastroenterol J. 2013;1:413–21.