Additional criteria on scintigraphic testing for diagnosis of rapid colonic transit in patients with chronic diarrhea.

IF 3.5 3区医学 Q1 CLINICAL NEUROLOGY

Neurogastroenterology and Motility Pub Date : 2024-11-01 Epub Date: 2024-09-20 DOI:10.1111/nmo.14917

Camille Lupianez-Merly, Saam Dilmaghani, Kara Jencks, Deborah Eckert, Michael Ryks, Duane Burton, Michael Camilleri

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引用次数: 0

Abstract

Background: Colonic transit (CT) measured by validated scintigraphy using ¹¹¹In-labeled activated charcoal particles is summarized using geometric center (GC) of isotopic distribution in four colonic regions and stool at 24 and 48 h. Diagnosis of rapid CT is currently based on GC24 ≥4.4 in females and >4.7 in males, which lack sensitivity. Our aim was to evaluate, in patients with chronic diarrhea with normal CT by GC24 and GC48, the diagnostic utility of CT change (∆GC) relative to sex-matched normal values.

Methods: We evaluated two adult patient cohorts: 701 clinical patients (1994-2023) with chronic diarrhea and 76 research participants with irritable bowel syndrome with diarrhea (N = 63) or bile acid diarrhea (BAD, N = 13). Results of ∆GC were compared to 220 healthy controls' 95th percentiles (%ile) (≥2.0 females and ≥2.2 males). In the research cohort, we also analyzed (Spearman correlation) colonic ∆GC with ascending colon emptying T_1/2 (AC T_1/2), average stool frequency and consistency based on a daily diary, total fecal bile acid (BA) concentration, and % primary BA in a single stool sample.

Key results: Among 701 clinical patients with normal GC24, 160 (22.3%) had rapid CT based on ∆GC 95th %ile in health. Among 76 research participants, an additional 20.6% IBS-D and 23% BAD had rapid CT ∆GC. Younger age and absence of diabetes mellitus were predictive of rapid ∆GC. ∆GC significantly correlated with AC T_1/2 and with fecal BA.

Conclusions & inferences: ∆GC identified an additional 21%-23% patients with rapid colonic transit among patients with diarrhea and normal GC24.

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诊断慢性腹泻患者结肠快速转运的闪烁成像测试附加标准。

背景：通过使用 111In 标记的活性炭颗粒进行有效的闪烁扫描测量结肠转运（CT），在 24 和 48 小时内使用结肠四个区域和粪便中同位素分布的几何中心（GC）进行总结。目前，快速 CT 的诊断依据是 GC24（女性）≥4.4 和 GC24（男性）>4.7，这缺乏敏感性。我们的目的是评估在 GC24 和 GC48 CT 正常的慢性腹泻患者中，CT 变化（∆GC）相对于性别匹配正常值的诊断效用：我们评估了两组成年患者：方法：我们评估了两个成年患者队列：701 名慢性腹泻临床患者（1994-2023 年）和 76 名患有肠易激综合征伴腹泻（N = 63）或胆汁酸腹泻（BAD，N = 13）的研究参与者。∆GC的结果与220名健康对照者的第95百分位数（%ile）（女性≥2.0，男性≥2.2）进行了比较。在研究队列中，我们还分析了结肠∆GC与升结肠排空T1/2（AC T1/2）、基于每日日记的平均大便次数和稠度、粪便胆汁酸（BA）总浓度以及单次大便样本中原生胆汁酸的百分比（斯皮尔曼相关性）：在 701 名 GC24 正常的临床患者中，有 160 人（22.3%）根据健康∆GC 第 95 百分位数患有快速 CT。在 76 名研究参与者中，另有 20.6% 的 IBS-D 和 23% 的 BAD 患有快速 CT ∆GC。年龄较小和无糖尿病是快速 ∆GC 的预测因素。∆ΔGC与AC T1/2和粪便BA明显相关：在腹泻和 GC24 正常的患者中，∆GC 发现了 21%-23% 的额外快速结肠转运患者。

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来源期刊

Neurogastroenterology and Motility 医学-临床神经学

CiteScore

7.80

自引率

8.60%

发文量

178

审稿时长

3-6 weeks

期刊介绍： Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.