Abnormal gut motility in inflammatory bowel disease: an update
Authors: M P Dore
E Antonelli
G Bassotti
R Nascimbeni
G Maconi
V Villanacci
G M Pes
Journal: Techniques in coloproctology (2020)
Discipline: CLINICAL MEDICINE
Keywords: Crohn’s disease; Gut dysmotility; Inflammatory bowel disease; Ulcerative colitis.
Affiliations: Gastroenterology and Hepatology Section, Department of Medicine, University of Perugia Medical School, Perugia, Italy. ., Clinica Di Gastroenterologia Ed Epatologia, Ospedale Santa Maria della Misericordia, Piazzale Menghini, 1, San Sisto, 06156, Perugia, Italy. ., Gastroenterology Unit, Perugia General Hospital, Perugia, Italy., Pathology Institute, Spedali Civili, Brescia, Italy., Surgical Section Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy., Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy., Gastroenterology Unit, Department of Biomedical and Clinical Sciences, L. Sacco University Hospital, Milan, Italy.

Abstract:  Background: There is substantial evidence linking disturbed gastrointestinal motility to inflammation. Thus, it is not surprising that abnormalities of gastrointestinal motility play a role in inflammatory bowel disease (IBD), affecting patient outcomes. We performed a review of the literature to investigate the relationship between abnormal gut motility and IBD. Methods: With an extensive literature search, we retrieved the pertinent articles linking disturbed gut motility to IBD in various anatomical districts. Results: The evidence in the literature suggests that abnormal gastrointestinal motility plays a role in the clinical setting of IBD and may confuse the clinical picture. Conclusions: Abnormal gut motility may be important in the clinical setting of IBD. However, additional data obtained with modern techniques (e.g., magnetic resonance imaging) are needed to individuate in a more precise manner gastrointestinal motor dysfunctions, to understand the nature of clinical manifestations and properly tailor the treatment of patients. 

Retracted: No

PubPeer comments:
 #1 If you are not already aware, it appears that the first author is an editor at this journal. *** ![file] , 
 There is another patient described in this  review with inactive ulcerative colitis that seems to have been subjected to intestinal (colon) manometry. Again, can the authors explain why this procedure was carried out? What is the benefit for an UC patient from having a manometry recording of the colon? Is this recommended in any guideline? Was the consent obtained from the patient?  Representative manometric tracing obtained in a patient with ulcerative colitis in remission, showing several low-amplitude propagated contractions (arrow) spanning from the descending colon to the rectum. Note that when these waves occur, there is relaxation of the anal sphincter. D descending colon, S sigmoid colon, R rectum, AS anal sphincter![file] , 
 In short, it is firmly established since al teast 25 years that manometric studies of small intestine and colon are of no benefit for IBD patients, because information obtained, if any, are irrelevant to the management of these patients. There is no guideline to support this practice; which is obviously un-ethical. , 
 ![file] **Representative manometric tracing of small bowel motility during fasting in a patients with active Crohnu2019s disease and inactive disease. Note the presence of clustered contractions (arrow). Recording points (5 cm apart) span from the mid-duodenum (first tracing) to the jejunum (last tracing) In the same authors words this technique IS HIGHLY INVASIVE and abandoned: ** u201cSmall bowel motility is usually investigated by means of manometric techniques, which require gut intubation and are uncomfortable to the patients; thus, manometric investigations of the small bowel in IBD patients are relatively few. In recent years alternative methods using noninvasive techniques have been proposed to assess small bowel motility [44]. For instance, some studies carried out in UC patients by means of capsule endoscopy or telemetric capsules have consistently shown a delayed transit in these patients [45,46,47].u201d Could the authors explain why this patient with Crohn disease was submitted to this invasive methology? The study involves exposure to X ray and last several hours: what is the patient benefit? Did the authors have obtained an informed consent from this patient? When the manometry was performed? ,