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Regional Gastrointestinal Transit Times in Patients With Carcinoid Diarrhea: Assessment With the Novel 3D-Transit System.

Gregersen T, Haase AM, Schlageter V, Gronbaek H, Krogh K - J Neurogastroenterol Motil (2015)

Bottom Line: Median colorectal transit time was 5.2 (range: 2.9-40.1) hours in patients versus 18.1 (range: 5.0-134.0) hours in healthy subjects (P = 0.012).Median frequency of pansegmental co-lonic movements was 0.45 (range: 0.03-1.02) per hour in patients and 0.07 (range: 0-0.61) per hour in healthy subjects (P = 0.045).The latter is caused by an increased frequency of pansegmental colonic movements.

View Article: PubMed Central - PubMed

Affiliation: Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

ABSTRACT

Background/aims: The paucity of knowledge regarding gastrointestinal motility in patients with neuroendocrine tumors and carcinoid diarrhea re-stricts targeted treatment. 3D-Transit is a novel, minimally invasive, ambulatory method for description of gastrointestinal motility. The system has not yet been evaluated in any group of patients. We aimed to test the performance of 3D-Transit in patients with carcinoid diarrhea and to compare the patients' regional gastrointestinal transit times (GITT) and colonic motility patterns with those of healthy subjects.

Methods: Fifteen healthy volunteers and seven patients with neuroendocrine tumor and at least 3 bowel movements per day were inves-tigated with 3D-Transit and standard radiopaque markers.

Results: Total GITT assessed with 3D-Transit and radiopaque markers were well correlated (Spearman's rho = 0.64, P = 0.002). Median total GITT was 12.5 (range: 8.5-47.2) hours in patients versus 25.1 (range: 13.1-142.3) hours in healthy (P = 0.007). There was no difference in gastric emptying (P = 0.778). Median small intestinal transit time was 3.8 (range: 1.4-5.5) hours in patients versus 4.4 (range: 1.8-7.2) hours in healthy subjects (P = 0.044). Median colorectal transit time was 5.2 (range: 2.9-40.1) hours in patients versus 18.1 (range: 5.0-134.0) hours in healthy subjects (P = 0.012). Median frequency of pansegmental co-lonic movements was 0.45 (range: 0.03-1.02) per hour in patients and 0.07 (range: 0-0.61) per hour in healthy subjects (P = 0.045).

Conclusions: Three-dimensional Transit allows assessment of regional GITT in patients with diarrhea. Patients with carcinoid diarrhea have faster than normal gastrointestinal transit due to faster small intestinal and colorectal transit times. The latter is caused by an increased frequency of pansegmental colonic movements.

No MeSH data available.


Related in: MedlinePlus

Gastrointestinal transit times in patients with neuroendocrine tumor (NET) and healthy subjects. (A) Small intestinal transit time measured in hours. (B) Colorectal transit time measured in hours. (C) Proximal colonic transit time measured in hours. (D) Total gastrointestinal transit time measured with 3D-Transit in hours. Lines represent the median values. SITT, small intestinal transit time; CRTT, colorectal transit time; GITT, total gastrointestinal transit time.
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f5-jnm-21-423: Gastrointestinal transit times in patients with neuroendocrine tumor (NET) and healthy subjects. (A) Small intestinal transit time measured in hours. (B) Colorectal transit time measured in hours. (C) Proximal colonic transit time measured in hours. (D) Total gastrointestinal transit time measured with 3D-Transit in hours. Lines represent the median values. SITT, small intestinal transit time; CRTT, colorectal transit time; GITT, total gastrointestinal transit time.

Mentions: There was no difference in gastric emptying but faster than normal small intestinal transit time (Table 2 and Fig. 5A). The transit through the colorectum was faster in patients with NET than in healthy subjects (Table 2 and Fig. 5B). Patients with NET had significantly faster transit through the proximal colon compared to healthy subjects (Fig. 5C) and there was a trend towards faster than normal transit in the middle/distal colon of patients with NET vs healthy (P = 0.101) (Table 2). Patients with NET had faster than normal total GI transit time (Table 2 and Fig. 5D). In patients with carcinoid diarrhea, there was an inverse correlation between serotonin levels and total GITT (Spearman’s rho = −0.89, P = 0.007). Correlations between total GITT and chromogranin A and U5-HIAA did not reach statistical significance (Spearman’s rho = −0.43, P = 0.34 and Spearman’s rho = −0.71, P = 0.11).


Regional Gastrointestinal Transit Times in Patients With Carcinoid Diarrhea: Assessment With the Novel 3D-Transit System.

Gregersen T, Haase AM, Schlageter V, Gronbaek H, Krogh K - J Neurogastroenterol Motil (2015)

Gastrointestinal transit times in patients with neuroendocrine tumor (NET) and healthy subjects. (A) Small intestinal transit time measured in hours. (B) Colorectal transit time measured in hours. (C) Proximal colonic transit time measured in hours. (D) Total gastrointestinal transit time measured with 3D-Transit in hours. Lines represent the median values. SITT, small intestinal transit time; CRTT, colorectal transit time; GITT, total gastrointestinal transit time.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496908&req=5

f5-jnm-21-423: Gastrointestinal transit times in patients with neuroendocrine tumor (NET) and healthy subjects. (A) Small intestinal transit time measured in hours. (B) Colorectal transit time measured in hours. (C) Proximal colonic transit time measured in hours. (D) Total gastrointestinal transit time measured with 3D-Transit in hours. Lines represent the median values. SITT, small intestinal transit time; CRTT, colorectal transit time; GITT, total gastrointestinal transit time.
Mentions: There was no difference in gastric emptying but faster than normal small intestinal transit time (Table 2 and Fig. 5A). The transit through the colorectum was faster in patients with NET than in healthy subjects (Table 2 and Fig. 5B). Patients with NET had significantly faster transit through the proximal colon compared to healthy subjects (Fig. 5C) and there was a trend towards faster than normal transit in the middle/distal colon of patients with NET vs healthy (P = 0.101) (Table 2). Patients with NET had faster than normal total GI transit time (Table 2 and Fig. 5D). In patients with carcinoid diarrhea, there was an inverse correlation between serotonin levels and total GITT (Spearman’s rho = −0.89, P = 0.007). Correlations between total GITT and chromogranin A and U5-HIAA did not reach statistical significance (Spearman’s rho = −0.43, P = 0.34 and Spearman’s rho = −0.71, P = 0.11).

Bottom Line: Median colorectal transit time was 5.2 (range: 2.9-40.1) hours in patients versus 18.1 (range: 5.0-134.0) hours in healthy subjects (P = 0.012).Median frequency of pansegmental co-lonic movements was 0.45 (range: 0.03-1.02) per hour in patients and 0.07 (range: 0-0.61) per hour in healthy subjects (P = 0.045).The latter is caused by an increased frequency of pansegmental colonic movements.

View Article: PubMed Central - PubMed

Affiliation: Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.

ABSTRACT

Background/aims: The paucity of knowledge regarding gastrointestinal motility in patients with neuroendocrine tumors and carcinoid diarrhea re-stricts targeted treatment. 3D-Transit is a novel, minimally invasive, ambulatory method for description of gastrointestinal motility. The system has not yet been evaluated in any group of patients. We aimed to test the performance of 3D-Transit in patients with carcinoid diarrhea and to compare the patients' regional gastrointestinal transit times (GITT) and colonic motility patterns with those of healthy subjects.

Methods: Fifteen healthy volunteers and seven patients with neuroendocrine tumor and at least 3 bowel movements per day were inves-tigated with 3D-Transit and standard radiopaque markers.

Results: Total GITT assessed with 3D-Transit and radiopaque markers were well correlated (Spearman's rho = 0.64, P = 0.002). Median total GITT was 12.5 (range: 8.5-47.2) hours in patients versus 25.1 (range: 13.1-142.3) hours in healthy (P = 0.007). There was no difference in gastric emptying (P = 0.778). Median small intestinal transit time was 3.8 (range: 1.4-5.5) hours in patients versus 4.4 (range: 1.8-7.2) hours in healthy subjects (P = 0.044). Median colorectal transit time was 5.2 (range: 2.9-40.1) hours in patients versus 18.1 (range: 5.0-134.0) hours in healthy subjects (P = 0.012). Median frequency of pansegmental co-lonic movements was 0.45 (range: 0.03-1.02) per hour in patients and 0.07 (range: 0-0.61) per hour in healthy subjects (P = 0.045).

Conclusions: Three-dimensional Transit allows assessment of regional GITT in patients with diarrhea. Patients with carcinoid diarrhea have faster than normal gastrointestinal transit due to faster small intestinal and colorectal transit times. The latter is caused by an increased frequency of pansegmental colonic movements.

No MeSH data available.


Related in: MedlinePlus