PMID- 31839961 OWN - NLM STAT- MEDLINE DCOM- 20200629 LR - 20220302 IS - 2050-6414 (Electronic) IS - 2050-6406 (Print) IS - 2050-6406 (Linking) VI - 7 IP - 10 DP - 2019 Dec TI - Increased fasting small-bowel water content in untreated coeliac disease and scleroderma as assessed by magnetic resonance imaging. PG - 1353-1360 LID - 10.1177/2050640619860372 [doi] AB - BACKGROUND AND AIMS: The regular overnight migrating motor complex (MMC) ensures that the normal fasting small-bowel water content (SBWC) is minimised. We have applied our recently validated non-invasive magnetic resonance technique to assess SBWC in newly diagnosed coeliac disease (CD), scleroderma (SCD) and irritable bowel syndrome (IBS), conditions possibly associated with small intestinal bacterial overgrowth (SIBO). METHODS: A total of 20 CD and 15 SCD patients with gastrointestinal symptoms were compared to 20 healthy volunteers (HV) and 26 IBS with diarrhoea (IBS-D) patients, as previously reported. All underwent a fasting magnetic resonance imaging (MRI) scan on a 1.5 T Philips Achieva MRI scanner to assess fasting SBWC and colonic volumes. Stool and symptom diaries were completed for one week. RESULTS: Compared to HV, all patients had significantly increased stool frequency and Bristol stool form score. SBWC was significantly increased in CD (median 109 mL; interquartile range (IQR) 53-224 mL) compared to HV (median 53 mL; IQR 31-98 mL; p < 0.01) and IBS-D (median 42 mL; IQR 28-67 mL; p < 0.01). A variable increase in SBWC was also found in SCD (median 77 mL; IQR 39-158 mL), but this was not significant (p = 0.2). Colonic volumes were similar for all groups, being a median of 547 mL (IQR 442-786 mL) for CD, 511 mL (453-789 mL) for SCD, 612 mL (445-746 mL) for HV and 521 mL (428-757 mL) for IBS-D. When CD patients were subdivided according to the Marsh classification, the higher grades had larger colonic volumes. CONCLUSION: Fasting SBWC as assessed by MRI is significantly increased in newly diagnosed CD and SCD but decreased in IBS-D. Future studies should test whether increased resting fluid predisposes to SIBO. CI - (c) Author(s) 2019. FAU - Lam, Ching AU - Lam C AD - Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. FAU - Sanders, David S AU - Sanders DS AD - Sheffield Teaching Hospitals NHS Foundation Trust and University of Sheffield, Sheffield, UK. FAU - Lanyon, Peter AU - Lanyon P AD - Nottingham University Hospitals Trust, Nottingham, UK. FAU - Garsed, Klara AU - Garsed K AD - Derby Teaching Hospitals NHS Foundation Trust, Derby, UK. FAU - Foley, Stephen AU - Foley S AD - Sherwood Forest Hospitals NHS Foundation Trust, Mansfield, UK. FAU - Pritchard, Susan AU - Pritchard S AD - Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, UK. FAU - Marciani, Luca AU - Marciani L AD - Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. FAU - Hoad, Caroline L AU - Hoad CL AD - Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. AD - Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, UK. FAU - Costigan, Carolyn AU - Costigan C AD - Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. FAU - Gowland, Penny AU - Gowland P AD - Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, UK. FAU - Spiller, Robin AU - Spiller R AUID- ORCID: 0000-0001-6371-4500 AD - Nottingham Digestive Diseases Centre, University of Nottingham and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK. LA - eng GR - MC_G1002464/MRC_/Medical Research Council/United Kingdom PT - Journal Article DEP - 20190621 PL - England TA - United European Gastroenterol J JT - United European gastroenterology journal JID - 101606807 RN - 059QF0KO0R (Water) SB - IM MH - Adult MH - Aged MH - Biopsy MH - Celiac Disease/*diagnosis/*metabolism/psychology MH - Fasting/*metabolism MH - Female MH - *Gastrointestinal Contents MH - Humans MH - Irritable Bowel Syndrome/diagnosis/metabolism MH - *Magnetic Resonance Imaging/methods MH - Male MH - Middle Aged MH - Scleroderma, Systemic/*diagnosis/*metabolism MH - Water/*metabolism PMC - PMC6894006 OTO - NOTNLM OT - Small bowel OT - coeliac disease OT - irritable bowel syndrome OT - magnetic resonance imaging OT - scleroderma EDAT- 2019/12/17 06:00 MHDA- 2020/07/01 06:00 PMCR- 2019/12/01 CRDT- 2019/12/17 06:00 PHST- 2019/02/25 00:00 [received] PHST- 2019/05/28 00:00 [accepted] PHST- 2019/12/17 06:00 [entrez] PHST- 2019/12/17 06:00 [pubmed] PHST- 2020/07/01 06:00 [medline] PHST- 2019/12/01 00:00 [pmc-release] AID - 10.1177_2050640619860372 [pii] AID - 10.1177/2050640619860372 [doi] PST - ppublish SO - United European Gastroenterol J. 2019 Dec;7(10):1353-1360. doi: 10.1177/2050640619860372. Epub 2019 Jun 21.