Colonic volume in patients with functional constipation or irritable bowel syndrome determined by magnetic resonance imaging

BACKGROUND: Functional constipation (FC) and irritable bowel syndrome constipation type (IBS‐C) share many similarities, and it remains unknown whether they are distinct entities or part of the same spectrum of disease. Magnetic resonance imaging (MRI) allows quantification of intraluminal fecal volume. We hypothesized that colonic volumes of patients with FC would be larger than those of patients with IBS‐C, and that both patient groups would have larger colonic volumes than healthy controls (HC). METHODS: Based on validated questionnaires, three groups of participants were classified into FC (n = 13), IBS‐C (n = 10), and HC (n = 19). The colonic volume of each subject was determined by MRI. Stool consistency was described by the Bristol stool scale and colonic transit times were assessed with radiopaque makers. KEY RESULTS: Overall, total colonic volumes were different in the three groups, HC (median 629 ml, interquartile range (IQR)(562–868)), FC (864 ml, IQR(742–940)), and IBS‐C (520 ml IQR(489–593)) (p = 0.001). Patients with IBS‐C had lower colonic volumes than patients with FC (p = 0.001) and HC (p = 0.019), but there was no difference between FC and HC (p = 0.10). Stool consistency was similar in the two patient groups, but patients with FC had longer colonic transit time than those with IBS‐C (117.6 h versus 43.2 h, p = 0.019). CONCLUSION: Patients with IBS‐C have lower total colonic volumes and shorter colonic transit times than patients with FC. Future studies are needed to confirm that colonic volume allows objective distinction between the two conditions

A clinical feasible method for computed tomography-based assessment of sarcopenia In patients with chronic pancreatitis

OBJECTIVES: Sarcopenia is a serious but often overlooked complication of chronic pancreatitis (CP). We investigated the prevalence and risk factors for sarcopenia in patients with CP and determined the utility of a computed tomography (CT)-based method, based on psoas muscle measurements, for easy and clinical feasible diagnosis of sarcopenia. METHODS: This was a retrospective multicenter study of 265 patients with CP. We used segmentation of CT images to quantify skeletal muscle mass and diagnose sarcopenia. On the same CT image as used for muscle segmentation, psoas muscle thickness and cross-sectional area were measured and receiver operating characteristic analyses defined age and sex-specific cutoffs for diagnosing sarcopenia. RESULTS: The prevalence of sarcopenia was 20.4%. The optimal height-adjusted psoas muscle cross-sectional area cutoff for diagnosing sarcopenia was 3.3 cm/m in males and 2.5 cm/m in females. The corresponding area under the receiver operating characteristic curves were 0.8 and 0.9, with sensitivities of 84% and 81% and specificities of 62% and 81%, respectively. Comparable diagnostic performance characteristics were observed for psoas muscle thickness. CONCLUSIONS: Sarcopenia is present in 1 of 5 patients with CP. Assessment of psoas muscle parameters provides a clinical feasible method to diagnose sarcopenia