Postprandial changes in gastrointestinal function and transit in cystic fibrosis assessed by Magnetic Resonance Imaging

Christabella Ng, Neele S. Dellschaft, Caroline L. Hoad, Luca Marciani, Lu Ban, Andrew P. Prayle, Helen L. Barr, Anke Jaudszus, Jochen G. Mainz, Robin C. Spiller, Penny Gowland, Giles Major, Alan R. Smyth*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

Background

Cystic fibrosis (CF) is a multi-system genetic disorder affecting >72,000 people worldwide. Most CF patients experience gastrointestinal symptoms and can develop complications. However, the mechanisms of CF gut disease are not well understood. We evaluated gut function and transit in CF using magnetic resonance imaging (MRI). We hypothesised oro-caecal transit time (OCTT) is longer in CF; with lower small bowel water content (SBWC).

Methods

Twelve CF patients aged 12–40 years and 12 age and sex-matched controls underwent serial MRIs over 1 day with standardised meals. The primary endpoint was OCTT, assessed by the appearance of a food bolus in the caecum. Other measures included corrected SBWC and corrected colonic volume (both area under the curve, AUC), gastric half-emptying time and gastrointestinal symptoms.

Results

OCTT was longer in CF (CF 330 mins [270, >360] vs. controls 210 mins [173, 315], p = 0.04), with no difference in gastric half-emptying times. Corrected SBWC was higher in CF (CF 62 L.min/m2 [36, 80] vs. controls 34 L.min/m2 [28, 41], p = 0.021); minimal postprandial decrease between T240 and T300 (CF 13 mL/m2 [-13, 57] vs. controls 102 mL/m2 [67, 108], p = 0.002) suggests impaired ileal emptying. Corrected colonic volumes were higher in CF (CF 186 L.min/m2 [167, 206] vs. controls 123 L.min/m2 [89, 146], p = 0.012). There were no differences in gastrointestinal symptoms.

Conclusions

MRI provides novel insights into CF pathophysiology. Sub-clinical ileal obstruction may be more prevalent than previously thought. Gastrointestinal MRI shows promise as an investigational tool in CF.

Original languageEnglish
Pages (from-to)591-597
Number of pages7
JournalJournal of Cystic Fibrosis
Volume20
Issue number4
Early online date16 Jun 2020
DOIs
Publication statusPublished - Jul 2021
Externally publishedYes

Bibliographical note

Funding Information:
APP reports grants from Thrasher Research Fund, grants from Action for A-T, grants from Health Education East Midlands, outside the submitted work; these grants are for the development of lung MRI in children and infants.

Funding Information:
Funding for the Gut Imaging for Function and Transit in CF (GIFT-CF) study was received from the Cystic Fibrosis Trust (VIA 061), Cystic Fibrosis Foundation (Clinical Pilot and Feasibility Award SMYTH18A0-I) and National Institute for Health Research Nottingham Biomedical Research Centre.

Publisher Copyright:
© 2020

Keywords

  • Cystic fibrosis
  • Gastrointestinal function
  • Gastrointestinal symptoms
  • MRI

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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