Cologastric Inhibition: Upper Gastrointestinal Dysfunction With Slow Colonic Transit

Area of Science:

• Gastroenterology
• Neurogastroenterology
• Digestive Physiology

Background:

• Coexistence of upper and lower gastrointestinal (GI) dysfunctions is common, potentially involving neural reflexes.
• Understanding the interplay between colonic and gastric function is crucial for diagnosing and managing GI motility disorders.

Purpose of the Study:

• To determine the prevalence of impaired gastric accommodation (GA) and delayed gastric emptying (GE) in patients with slow colonic transit (CT) and dyssynergic defecation (DD).
• To investigate the relationship between CT or DD and impaired GA or delayed GE.

Main Methods:

• Retrospective analysis of 178 adult patients with documented slow CT or DD.
• Assessment of GA and GE using 99mTc-SPECT and scintigraphy after a standardized egg meal.
• Correlation analysis using Spearman rank test to evaluate relationships between variables.

Main Results:

• Slow CT was associated with delayed GE (35.6% of patients), suggesting cologastric reflex inhibition.
• Impaired GA was observed in a significant proportion of patients with DD (23.7%) and slow CT (26.7%).
• No significant correlation was found between CT and GA, but CT showed correlations with GE.

Conclusions:

• Slow CT is associated with delayed GE, but not with impaired GA, supporting the role of cologastric reflexes.
• A high prevalence of impaired GA and delayed GE exists in patients with slow CT and DD.
• These findings highlight the frequent co-occurrence of upper and lower GI motility disturbances.