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Increased fasting small-bowel water content in untreated coeliac disease and scleroderma as assessed by magnetic resonance imaging

Lam, Ching; Sanders, David; Lanyon, Peter; Garsed, Klara; Foley, Stephen; Pritchard, Susan; Marciani, Luca; Hoad, Caroline L.; Costigan, Carolyn; Gowland, Penny; Spiller, Robin

Authors

Ching Lam

David Sanders

Peter Lanyon

Klara Garsed

Stephen Foley

Susan Pritchard

Luca Marciani

Caroline L. Hoad

Carolyn Costigan

Penny Gowland

Robin Spiller



Abstract

Background and aims: The regular overnight migrating motor complex (MMC) ensures that the normal fasting small bowel water content (SBWC) is minimised. We have applied our recently validated non-invasive magnetic resonance technique to assess SBWC in newly diagnosed coeliac disease (CD), scleroderma (SCD) and irritable bowel syndrome (IBS) conditions, possibly associated with small intestinal bacterial overgrowth (SIBO).

Methods: 20 CD and 15 SCD patients with gastrointestinal symptoms were compared to 20 healthy volunteers (HV) and 26 IBS with diarrhoea (IBS-D) patients as previously reported. All underwent a fasting, magnetic resonance imaging (MRI) scan on a 1.5 T Philips Achieva MRI scanner to assess fasting SBWC and colonic volumes. Stool and symptom diaries were completed for 1 week.

Results: Median (Interquartile range, IQR)
Compared to healthy volunteers, all the patients had significantly increased stool frequency and Bristol stool form score. SBWC was significantly increased in CD 109(53-224) vs. 53(31-98) mL in HV, p [less than] 0.01 and 42 (28-67) in IBS-D, p [less than] 0.01. Variable increase in SBWC was also found in SCD, median 77(39-158) but this was not significant, p=0.2. Colonic volumes were similar for all groups being 547 (442-786) for CD, 511 (453-789) for SCD, 612 (445-746) for HV and 521 (428-757) mL for IBS-D. When CD patients were subdivided according to the Marsh classification, the higher grades had larger colonic volumes.

Conclusion: Fasting SBWC as assessed by MRI is significantly increased in newly diagnosed CD and SCD but decreased in IBS-D. Future studies should test whether increased resting fluid predisposes to SIBO.

Journal Article Type Article
Publication Date Jun 21, 2019
Journal United European Gastroenterology Journal
Print ISSN 2050-6406
Electronic ISSN 2050-6414
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Institution Citation Lam, C., Sanders, D., Lanyon, P., Garsed, K., Foley, S., Pritchard, S., …Spiller, R. (2019). Increased fasting small-bowel water content in untreated coeliac disease and scleroderma as assessed by magnetic resonance imaging. United European Gastroenterology Journal, https://doi.org/10.1177/2050640619860372
DOI https://doi.org/10.1177/2050640619860372
Keywords Small bowel; Magnetic resonance imaging; Irritable bowel syndrome; Coeliac disease; Scleroderma
Publisher URL https://journals.sagepub.com/doi/full/10.1177/2050640619860372
Additional Information Lam, C., Sanders, D. S., Lanyon, P., Garsed, K., Foley, S., Pritchard, S., … Spiller, R. (2019). Increased fasting small-bowel water content in untreated coeliac disease and scleroderma as assessed by magnetic resonance imaging. United European Gastroenterology Journal. https://doi.org/10.1177/2050640619860372

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