Small bowel motor abnormalities in malnourished symptomatic adults complaining of severe digestive symptoms with and without functional subocclusive episodes

Abstract

Aim. To compare small bowel manometric findings in patients with severe digestive symptoms and inability to maintain a normal body weight, with or without recurrent subocclusive episodes in the absence of mechanical obstruction. Methods. Small bowel manometry was performed (fasting> 6h, post-prandial> Ih) by a traditional stationary perfused technique in 62 patients (34.5 ± 12.8 yrs, mean + SD; 57 F) with severe GI symptoms and inability to maintain a normal body weight (BMI 2) radiologically proven subocclusive episodes (distended intestinal loops I airfluid levels) (GROUP A), while the remaining 37 (34.0± 11.9 yrs, mean+SD; 35 F) had not (GROUP B). Organic. systemic and metabolic diseases were ruled out in all patients. The following abnormal motor patterns were visually analysed: abnormalactivity fronts (AbnAFs), bursts, hypermotility, inability to produce a fed pattern (No-FED), clustered contractions (clusters). RESULTS. Patients in GROUP A had undergone a higher number of abdominal surgeries before coming to our laboratory (3.80±2.51 vs 0.94±1.58; p<O.OOI, Mann-Whitney). At least one motor abnormality was recorded in all patients in both groups (see table). CONCLUSIONS. Small bowel motor abnormalities are invariably present in patients with severe digestive symptoms and inability to maintain a normal body weight, regardless of the presence of functional intestinal subocclusions. Patients with recurrent subocclusions have a significatively higher frequency of abnormal motor patterns suggestive of a greater derangement of the control mechanisms of gut motility.