Evaluation of gastric and small bowel transit times in coeliac disease with the small bowel PillCam®: a single centre study in a non gluten-free diet adult italian population with coeliac disease

R. Urgesi, R. Cianci, A. Bizzotto, G. Costamagna, M.E. Riccioni

Digestive Endoscopy Unit, and 3Institute of Internal Medicine; School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. riurgesi@tin.it

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• Gastroenterology

BACKGROUND: The mechanisms underlying bowel disturbances in coeliac disease are still relatively unclear. Past reports suggested that small bowel motor abnormalities may be involved in this pathological condition; there are no studies addressing small bowel transit in coeliac disease before and after a gluten-free diet.

AIM: The objective of this study was to determine whether capsule endoscopy (CE) could serve as a test for measurement of gastric and small bowel transit times in a group of symptomatic or asymptomatic coeliac patients at the time of diagnosis with respect to a control group.

PATIENTS AND METHODS: Thirty coeliac untreated patients and 30 age-, sex- and BMI-matched healthy controls underwent CE assessment of whole gut transit times.

RESULTS: All subjects completed the study per protocol and experienced natural passage of the pill. No statistical significant differences between gastric emptying and small bowel transit times both in coeliac and control group were found (p = 0.1842 and p = 0.7134; C.I. 95%, respectively). No correlation was found in coeliac patients and control group between transit times and age, sex and BMI. By using the Pearson’s correlation test, significant correlation emerged between gastric emptying time and small bowel transit times in coeliac disease (r = 0.1706).

CONCLUSIONS: CE reveals unrecognized gender differences and may be a novel outpatient technique for gut transit times’ assessment without exposure to radiation and for the evaluation of upper gut dysfunction in healthy patients suffering from constipation without evidence of intestinal malabsorption. Nevertheless, CE does not seem to be the most suitable method for studying gut transit times in untreated coeliac patients; this might be ascribed to the fact that CE consists of inert (non-digestible, non-absorbable) substances.

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