Expert Position Statement: Defining the Role of Intestinal Ultrasound in Assessing Constipation and Faecal Loading

Area of Science:

• Gastroenterology
• Medical Imaging
• Functional Gastrointestinal Disorders

Background:

• Intestinal ultrasound (IUS) shows promise for evaluating non-inflammatory functional gastrointestinal disorders like constipation and faecal loading.
• Current diagnostic approaches lack standardized sonographic criteria for these conditions.

Purpose of the Study:

• To establish specific sonographic parameters for assessing constipation and faecal loading using intestinal ultrasound.
• To develop consensus among experts on the utility of IUS in functional gastrointestinal disorders.

Main Methods:

• A multidisciplinary international expert panel (14 gastroenterologists, 1 radiologist) utilized the Research and Development/University of California Los Angeles appropriateness method.
• Experts rated 57 statements on a 9-point Likert scale over two voting rounds to determine consensus on IUS application and parameters.

Main Results:

• Intestinal ultrasound was deemed an appropriate modality for assessing faecal loading.
• Key sonographic parameters for faecal loading include posterior acoustic shadowing and echogenic reflections.
• A rectal diameter of 30 mm was suggested for paediatric faecal loading assessment; adult criteria require further research.

Conclusions:

• An expert panel affirmed intestinal ultrasound as suitable for evaluating constipation and faecal loading.
• Further prospective studies are essential, particularly in adult populations, to define sonographic metrics for luminal contents.
• Expanding the application of IUS in functional gastrointestinal disorders necessitates refined sonographic criteria.