Features of digestive system’s motor activity in patients with coeliac disease
L. Oreshko, M. Zhuravleva
I. I. Mechnikov North-Western State Medical University, St. Petersburg, Russian Federation, firstname.lastname@example.org
Coeliac disease is one of the best examples of chronic digestive disease, where clinical appearance is characterised by combined motility disorders of various parts of the digestive tube and dysfunctions in the sphincter system.
To estimate the motility and evacuation disorders of gastrointestinal tract in adults with coeliac disease.
27 patients with coeliac disease diagnosed by upper-endoscopy, histology of duodenum biopsy specimens and HLA-typing were examined. The age of patients ranged from 19 to 57 years (mean age=38±13.85). 10 male and 17 female patients included in the study. Functional motility disorders were assessed in all patients by peripheral electrogastroenterography (EGEG) using gastroenteromonitor GEM-01 (Gastroscan-GEM).
Results of EGEG showed the signs of disturbances in tonus and rhythmicity of the stomach and the duodenum, contraction discoordination between the stomach and the duodenum, the ileum and the large bowel, gastroesophageal refux (GER) and duodenogastric refux (DGR) on an empty stomach and after standard food stimulation. Values of basal and stimulated levels of the studied parameters were considered as markers of inadequate response of the stomach and the duodenum (decline in absolute and percentile electrical energy, rhythmicity and amplitude parameters in food stimulation compared with basal values), hypertonus of the stomach (Pi/Ps above 34.0%) and the duodenum (Pi/Ps above 3.3%), contraction discoordination between the stomach and duodenum (comparison index [CI] above 16.0), as well as between the ileum and the large intestine (CI 0.21), GER and DGR, motility retardation of the large intestine (rhythmicity index in food stimulation <13.0). The most common combinations were hypertonus of the stomach, its inadequate response to food stimulation with GER and contraction discoordination between the stomach and the duodenum. Contraction discoordination between the stomach and the duodenum were often combined with DGR. The hypertonus of the ileum and the jejunum on an empty stomach were often combined with contraction discoordination between ileum and large intestine.
EGEG data obtained showed the need for improvement in pathogenic therapy of coeliac disease aimed at correction of gastrointestinal motility disorders.