ABNORMAL GASTROINTESTINAL MOTILITY IN PATIENTS WITH CELIAC SPRUE

No study to date has objectively investigated whether the motor behavi or of the small bowel is abnormal in celiac sprue. The purpose of this study was to systematically address this topic by means of intralumin al pressure recordings in a series of such patients. Sixteen subjects (nine adults, seven children, age range 2-69 years) with celiac sprue were recruited and studied while untreated. Manometric examination was carried out for 6 hr during fasting and 3 hr after a meal. Adult celi ac patients displayed a significantly (mean +/- SEM) greater frequency of migrating motor complexes in comparison to controls during fasting (4.44 +/- 1.6 vs 2.45 +/- 0.20, P < 0.01), whereas no differences wer e found in the pediatric group with respect to this variable. Fasting motor abnormalities, chiefly represented by discrete clustered contrac tions, giant jejunal contractions, and bursts of nonpropagated contrac tions, were discovered in a high percentage in both groups of celiac s ubjects (89% in adults and 44% in children, respectively). Similar abn ormalities were observed in the postprandial period, especially in adu lts. In conclusion, patients with celiac sprue frequently display disc rete gastrointestinal motor abnormalities, which though perhaps nonspe cific may account for several symptoms complained of by such patients.