Abstract
Study design:
Spinal cord injury (SCI) results in gastrointestinal (GI) complications, including gastroesophageal reflux disease and constipation, but much of the data is based on older technology.
Objective:
GI transit times were determined in subjects with SCI using a new device called a SmartPill. Our principal goal was to assess whether this new technology can be applied in persons with SCI.
Methods:
SCI and age- and gender-matched able-bodied (AB) control subjects not taking proton pump inhibitors were studied. Following an 8-h overnight fast, subjects consumed 120 g EggBeaters (60 kcal), two slices of white bread (120 kcal) and 30 g strawberry jam (74 kcal). A pH calibrated SmartPill capsule was swallowed with 8 ounces of water, after which subjects fasted for an additional 6 h prior to consuming an Ensure Plus nutrition shake (350 kcal). Subjects remained fasted for an additional 2 h, after which time they resumed their regular diets.
Results:
Twenty subjects with SCI and 10 AB control subjects were studied. Data are expressed as mean±s.d. Comparing the group with SCI to the AB control group, gastric emptying time (GET), colonic transit time (CTT) and whole gut transit time (WGTT) were prolonged (GET: 10.6±7.2 vs 3.5±1.0 h, P<0.01; CTT: 52.3±42.9 vs 14.2±7.6 h, P=0.01; WGTT: 3.3±2.5 vs 1.0±0.7 days, P<0.01). No complications or side effects were reported.
Conclusion:
Our results indicate that the SmartPill technology is a safe, non-invasive assessment technique that provides valid diagnostic information in persons with SCI.
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References
Verbeke K, de Preter V, Geboes K, Daems T, van den Mooter G, Evenepoel P et al. In vivo evaluation of a colonic delivery system using isotope techniques. Aliment Pharmacol Ther 2005; 21: 187–194.
Kasicka-Jonderko A, Kotula I, Sojka E, Syrkiewicz-Trepiak D, Jonderko K . [Application of the hydrogen breath test for the evaluation of oro-caecal transit time]. Wiad Lek 2003; 56: 172–179.
Kuo B, McCallum RW, Koch KL, Sitrin MD, Wo JM, Chey WD et al. Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects. Aliment Pharmacol Ther 2008; 27: 186–196.
Cassilly D, Kantor S, Knight LC, Maurer AH, Fisher RS, Semler J et al. Gastric emptying of a non-digestible solid: assessment with simultaneous SmartPill pH and pressure capsule, antroduodenal manometry, gastric emptying scintigraphy. Neurogastroenterol Motil 2008; 20: 311–319.
Segal JL, Milne N, Brunnemann SR . Gastric emptying is impaired in patients with spinal cord injury. Am J Gastroenterol 1995; 90: 466–470.
Kao CH, Ho YJ, Changlai SP, Ding HJ . Gastric emptying in spinal cord injury patients. Dig Dis Sci 1999; 44: 1512–1515.
Zhang RL, Chayes Z, Korsten MA, Bauman WA . Gastric emptying rates to liquid or solid meals appear to be unaffected by spinal cord injury. Am J Gastroenterol 1994; 89: 1856–1858.
Singal AK, Rosman AS, Bauman WA, Korsten MA . Recent concepts in the management of bowel problems after spinal cord injury. Adv Med Sci 2006; 51: 15–22.
Fajardo NR, Pasiliao RV, Modeste-Duncan R, Creasey G, Bauman WA, Korsten MA . Decreased colonic motility in persons with chronic spinal cord injury. Am J Gastroenterol 2003; 98: 128–134.
Menardo G, Bausano G, Corazziari E, Fazio A, Marangi A, Genta V et al. Large-bowel transit in paraplegic patients. Dis Colon Rectum 1987; 30: 924–928.
Leduc BE, Giasson M, Favreau-Ethier M, Lepage Y . Colonic transit time after spinal cord injury. J Spinal Cord Med 1997; 20: 416–421.
Acknowledgements
The Department of Veteran Affairs Rehabilitation Research and Development Service Center of Excellence for the Medical Consequences of Spinal Cord Injury (#B4162-C) and the James J Peters VA Medical Center have provided the support that made this work possible.
Guarantor of the article: Mark A Korsten, MD, is accepting full responsibility for the conduct of the study.
Specific author contributions: Robert E Williams III, MS, was responsible for the development of the study protocol, obtaining local human subjects committee approval, supervising and implementing the study. He was involved in data collection, analysis and interpretation. Mr Williams is the first author of this manuscript, and he has approved the final draft submitted for consideration for publication.
Dr William A Bauman assisted in writing the protocol and supported its performance. Dr Bauman was closely involved in writing and editing the manuscript, and he has approved the final draft that is being submitted for consideration for publication.
Dr Ann M Spungen assisted in the development and implementation of the protocol, data analysis and writing the manuscript. Dr Spungen has approved the final draft submitted for consideration for publication.
Dr Ravi R Vinnakota consented subjects, implemented study procedures and compiled final reports for each subject. Dr Vinnakota has approved the final draft submitted for consideration for publication.
Dr Rany Z Farid consented subjects, implemented study procedures and compiled final reports for each subject. Dr Farid has approved the final draft submitted for consideration for publication.
Dr Marinella Galea was responsible for identifying eligible subjects for study participation. Following completion of the study, she assisted in analysis and interpretation of the findings. Dr Galea has approved the final draft submitted for consideration for publication.
Dr Mark A Korsten was the primary investigator on the study protocol, and he is the Chief of the Gastroenterology Service at the James J Peters VA Medical Center. Dr Korsten was responsible for acquiring the SmartPill technology used in this study and supervised all study activities, including data collection, analysis and interpretation. Dr Korsten has approved the final draft submitted for consideration for publication.
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Williams, R., Bauman, W., Spungen, A. et al. SmartPill technology provides safe and effective assessment of gastrointestinal function in persons with spinal cord injury. Spinal Cord 50, 81–84 (2012). https://doi.org/10.1038/sc.2011.92
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DOI: https://doi.org/10.1038/sc.2011.92
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