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

Authors

  • S. E. Pritchard,

    1. Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
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  • L. Marciani,

    1. Nottingham Digestive Diseases Centre, School of Clinical Sciences, University of Nottingham, Nottingham, UK
    2. Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, UK
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  • K. C. Garsed,

    1. Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, UK
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  • C. L. Hoad,

    1. Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
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  • W. Thongborisute,

    1. Nottingham Digestive Diseases Centre, School of Clinical Sciences, University of Nottingham, Nottingham, UK
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  • E. Roberts,

    1. Nottingham Digestive Diseases Centre, School of Clinical Sciences, University of Nottingham, Nottingham, UK
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  • P. A. Gowland,

    1. Sir Peter Mansfield Magnetic Resonance Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
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  • R. C. Spiller

    Corresponding author
    1. Nottingham Digestive Diseases Centre, School of Clinical Sciences, University of Nottingham, Nottingham, UK
    2. Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals, University of Nottingham, Nottingham, UK
    • Address for Correspondence

      Prof Robin C. Spiller, Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, E Floor, West Block, Nottingham University Hospitals, University of Nottingham, Nottingham NG7 2UH, UK.

      Tel: +44 (0) 115 8231090; fax: +44 (0) 115 8231409; e-mail: Robin.Spiller@nottingham.ac.uk

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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.

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