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Detecting the effects of a standardized meal challenge on small bowel motility with MRI in prepared and unprepared bowel
Author(s) -
de Jonge Catharina S.,
Menys Alex,
van Rijn Kyra L.,
Bredenoord Arjan J.,
Nederveen Aart J.,
Stoker Jaap
Publication year - 2019
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13506
Subject(s) - motility , medicine , mannitol , meal , gastroenterology , stimulation , chemistry , biology , biochemistry , genetics
Objective MRI is increasingly used to evaluate small bowel contractility. The objective of this study was to validate a clinically practical stimulation test (300‐kcal meal) for small bowel motility. Methods Thirty‐one healthy subjects underwent dynamic MRI to capture global small bowel motility after ±10h fasting, of which 15 underwent bowel preparation consisting of 1 L 2.5% mannitol solution and 16 did not. Each subject underwent (1) a baseline motility scan (2) a food challenge (3) a post‐challenge scan, and (4) second post‐challenge scan (after ±20 minutes). This protocol was repeated within 2 weeks. Motility was quantified using a validated motility assessment technique. Key Results Motility in prepared subjects at baseline was significantly higher than motility in unprepared subjects (0.36 AU vs 0.18 AU, P < 0.001). In the prepared group, the food challenge produced an 8% increase in motility ( P = 0.33) while in the unprepared subjects a significant increase of 30% was observed ( P < 0.001). Responses to food remained insignificant ( P = 0.21) and significant ( P = 0.003), for the prepared and unprepared subjects, respectively, ±20 minutes post food challenge. These results were confirmed in the repeated scan session. Conclusion & Inferences A significant response to a 300‐kcal meal was measured within 10 minutes in unprepared bowel, supporting the clinical use of this challenge to provoke and assess motility changes. A caloric challenge did not produce an observable increase in motility in mannitol prepared subjects.