Gastrointestinal motility examined by wireless motility capsule (SmartPill®) and gut hormone profiles in inflammatory bowel diseases : Motility and hormones inIBD

• Background: Inflammatory bowel disease (IBD) is associated with vague gastrointestinal (GI) discomfort even when inflammation is in clinical remission. In Crohn’s disease (CD) and ulcerative colitis (UC) motility disorders have been described throughout the GI tract. In clinics, considerable patient discomfort relates to symtoms of dysmotility (e.g., intestinal cramping, distension or diarrhea), which present in active and inactive disease. Treatment requires diagnostic methods to identify pathologies throughout the gut during meals while also evaluating gut peptide hormone changes.Methods: SmartPill® wireless motility capsule (WMC) technique to identify pH and motility derangements along the GI tract. pH, luminal pressure, transit time and prandial peptide hormone changes were compared between either 10 CD patients or 10 UC patients relative 20 age- and sex-matched healthy controls.Results: Motility index was significantly reduced in the stomach and contraction frequency and peak pressures were reduced in CD. Small bowel motility index was reduced in UC. In CD, meal responses of ghrelin, GIP, PYY and leptin, and to a lesser extent GLP-1, showed elevated plasma levels. In UC, ghrelin, GIP and GLP-1, but not PYY and leptin were elevated. Neither had a clear relationship to the motility discrepancies.Conclusion: Enhanced endocrine meal responses may be a cause or result of motility disturbances in IBD, but cannot be broken down by individual peptides. These observations potentially give pathophysiological explanations for GI disturbances in IBD, opening the possibility for pharmacological treatment.

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Medicinsk vetenskap

Medical Science

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vet (subject category)

ovr (subject category)