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Fasting and postprandial volumes of the undisturbed colon: normal values and changes in diarrhea-predominant irritable bowel syndrome measured using serial MRI

Pritchard, Susan E.; Marciani, Luca; Garsed, K.C.; Hoad, Caroline; Thongborisute, W.; Roberts, E.; Gowland, Penny A.; Spiller, Robin C.

Authors

Susan E. Pritchard

Luca Marciani Luca.Marciani@nottingham.ac.uk

K.C. Garsed

Caroline Hoad

W. Thongborisute

E. Roberts

Penny A. Gowland

Robin C. Spiller



Abstract

Background
Previous assessments of colon morphology have relied on tests which were either invasive or used ionizing radiation. We aimed to measure regional volumes of the undisturbed colon in healthy volunteers (HV) and patients with diarrhea-predominant irritable bowel syndrome (IBS-D).
Methods
3D regional (ascending, transverse, and descending) colon volumes were measured in fasting abdominal magnetic resonance (MR) images of 75 HVs and 25 IBS-D patients. Thirty-five of the HV and all 25 IBS-D subjects were fed a standard meal and postprandial MRI data obtained over 225 min.
Key Results
Colonic regions were identified and 3D maps from cecum to sigmoid flexure were defined. Fasted regional volumes showed wide variation in both HVs being (mean ± SD) ascending colon (AC) 203 ± 75 mL, transverse (TC) 198 ± 79 mL, and descending (DC) 160 ± 86 mL with no difference from IBS-D subjects (AC 205 ± 69 mL, TC 232 ± 100 mL, and DC 151 ± 71 mL, respectively). The AC volume expanded by 10% after feeding (p = 0.007) in the 35 HV possibly due to increased ileo-colonic inflow. A later rise in AC volume occurred from t = 90 to t = 240 min as the meal residue entered the cecum. In contrast, IBS-D subjects showed a much reduced postprandial response of the AC (p < 0.0001) and a greater increase in TC volume after 90 min (p = 0.0244) compared to HV.
Conclusions & Inferences
We have defined a normal range of the regional volumes of the undisturbed colon in fasted and fed states. The AC in IBS-D appeared less able to accommodate postprandial inflow which may account for faster colonic transit.

Journal Article Type Article
Journal Neurogastroenterology & Motility
Electronic ISSN 1350-1925
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 26
Issue 1
Institution Citation Pritchard, S. E., Marciani, L., Garsed, K., Hoad, C., Thongborisute, W., Roberts, E., …Spiller, R. C. (in press). Fasting and postprandial volumes of the undisturbed colon: normal values and changes in diarrhea-predominant irritable bowel syndrome measured using serial MRI. Neurogastroenterology and Motility, 26(1), doi:10.1111/nmo.12243
DOI https://doi.org/10.1111/nmo.12243
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/nmo.12243/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by-nc/4.0





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