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Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation
Published on: September 22, 2023
Intestinal Ultrasound Adds Diagnostic Value and Safety to a Dietitian-Led Clinic for Disorders of Gut-Brain
R M Mathias1,2,3, S L Plush1,2,3,4, L E Edwards5
1Department of Gastroenterology The Queen Elizabeth Hospital Adelaide South Australia Australia.
Background:
Disorders of gut-brain interaction (DGBI) affect approximately 40% of the global population. Multidisciplinary models incorporating dietetic management are increasingly used, yet objective assessment tools remain limited. This study evaluated the clinical utility of intestinal ultrasound (IUS) within a dietitian-led DGBI clinic.
Methods:
Consecutive patients underwent IUS at baseline and after dietetic intervention. Irritable bowel syndrome severity scores (IBS-SSS) and sonographic parameters were recorded at both visits. Fecal loading was defined by posterior acoustic shadowing and/or colonic diameter > 50 mm. Patient satisfaction was assessed using a 100-point Visual Analog Scale (VAS), with scores ≥ 75 indicating satisfaction.
Results:
Ninety-seven patients underwent IUS: 85 met Rome IV criteria for irritable bowel syndrome, 7 for functional constipation, and 5 for functional diarrhea. IUS confirmed the clinical diagnosis in 67% (65/97) and led to management changes in 28% (27/97). Fecal loading was identified in 22% (6/27) of patients reporting diarrhea. Mean satisfaction with IUS was high (97; 95% CI: 87.5-100). Sequential IUS was performed in 38 patients; management of IUS-defined fecal loading significantly reduced colonic diameter (p < 0.001) and posterior acoustic shadowing (p < 0.001), with corresponding improvement in IBS-SSS scores (p < 0.0001). New inflammatory bowel disease was detected in 3 (8%) patients.
Conclusion:
IUS enhances diagnostic confidence and informs management in a dietitian-led DGBI clinic. It represents a safe, well-tolerated, and cost-effective adjunct to clinical assessment, supporting its integration into multidisciplinary models of care. Further studies should clarify its role in functional gastrointestinal evaluation.
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