Simple clinical assessment of colonic response to food

The colonic response to food (CRF) is an integrated function of the colon t hat has been poorly studied in clinical practice. This study describes a ne w method to measure it, based on the progress of radio-opaque markers, and shows the results in healthy subjects and in patients with irritable bowel syndrome (IBS). Thirty healthy subjects and 43 patients suffering from IBS were studied. Two studies of colonic transit time (CTT), at rest and after eating a standard test meal, were performed. CRF was quantified by calculat ing the Variation in number of markers in each zone of interest of the larg e bowel using X-ray films of the abdomen taken before and after eating. The results were as follows: (1) CRF is characterised by caudal propulsion of the colonic contents in the two groups. In controls, there is emptying of t he cecum-ascending colon region and filling of the distal large bowel. In I BS patients, only emptying of the left transverse colon and the splenic fle xure is found. (2) IBS patients have a delayed CTT because of slowing in th e right and left colon, and this is both before and after a meal. The deter mination of the movements of markers after eating is a simple method that i s useful in clinical practice to evaluate CRF.