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Background: Functional constipation (FC) and irritable bowel syndrome constipation type (IBS‐C) share many similarities, and it remains unknown whether they are distinct entities or part of the same spectrum of disease. Magnetic resonance imaging (MRI) allows quantification of intraluminal fecal volume. We hypothesized that colonic volumes of patients with FC would be larger than those of patients with IBS‐C, and that both patient groups would have larger colonic volumes than healthy controls (HC). Methods: Based on validated questionnaires, three groups of participants were classified into FC (n = 13), IBS‐C (n = 10), and HC (n = 19). The colonic volume of each subject was determined by MRI. Stool consistency was described by the Bristol stool scale and colonic transit times were assessed with radiopaque makers. Key Results: Overall, total colonic volumes were different in the three groups, HC (median 629 ml, interquartile range (IQR)(562–868)), FC (864 ml, IQR(742–940)), and IBS‐C (520 ml IQR(489–593)) (p = 0.001). Patients with IBS‐C had lower colonic volumes than patients with FC (p = 0.001) and HC (p = 0.019), but there was no difference between FC and HC (p = 0.10). Stool consistency was similar in the two patient groups, but patients with FC had longer colonic transit time than those with IBS‐C (117.6 h versus 43.2 h, p = 0.019). Conclusion: Patients with IBS‐C have lower total colonic volumes and shorter colonic transit times than patients with FC. Future studies are needed to confirm that colonic volume allows objective distinction between the two conditions. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal (GI) symptoms are common in patients with diabetes mellitus (DM). The electromagnetic 3D‐Transit system allows assessment of regional transit times and motility patterns throughout the GI tract. We aimed to compare GI transit times and detailed motility patterns of the colon in patients with DM and GI symptoms to those of healthy controls (HC). We further aimed to determine whether any abnormalities in motility were reversible by cholinergic stimulation. Methods: We compared 18 patients with DM with 20 HC by means of the 3D‐Transit system. Patients were studied before and during oral administration of 60 mg pyridostigmine. Key results: Compared to HC, patients had prolonged gastric emptying (DM: 3.3 hours (interquartile range (IQR) 2.6‐4.6); HC: 2.3 hours (IQR 1.7‐2.7) (P <.01)), colonic transit time (DM: 52.6 hours (IQR 23.3‐83.0); HC: 22.4 hours (IQR 18.9‐43.6) (P =.02)), and whole gut transit time (DM: 69.4 hours (IQR 32.9‐103.6); HC: 30.3 hours (IQR 25.2‐49.9) (P <.01)). In addition, compared to HC, patients had prolonged transit time in the ascending colon (DM: 20.5 hours (IQR 11.0‐44.0); HC: 8.0 hours (IQR 3.8‐21.0) (P <.05)) and more slow retrograde movements in the colon (DM: 2 movements (IQR 1‐4); HC: 1 movement (IQR 0‐1) (P =.01)). In patients, pyridostigmine increased the number of bowel movements (P <.01) and reduced small intestine transit times (P <.05). Conclusions: Patients with DM and GI symptoms have longer than normal GI transit times. This is only partly reversible by pyridostigmine. The increased number of retrograde colonic movements in patients could potentially explain the abnormally long transit time in proximal colon. [ABSTRACT FROM AUTHOR]

Background: The Motilis 3D‐Transit system allows ambulatory description of transit patterns throughout the gastrointestinal tract and offers an alternative method for studying gastric motility. We aimed to establish normative values for gastric motility assessed with the method. Method: A total of 132 healthy volunteers ingested the 3D‐Transit capsule for assessment of gastrointestinal transit times. Recordings from 125 subjects were used for definition of normative values. Forty‐six subjects were studied on two consecutive days. Recordings were reanalyzed using newly developed software providing information on gastric emptying (GE) as well as contraction frequency and movement during gastric contractions. Results: The median GE time was 2.7 hours (range 0.1‐21.2). In 89% of subjects, the capsule passed the pylorus within a postingestion period of 6 hours. The median frequency of gastric contractions was 3.1 per minute (range 2.6‐3.8). The frequency was higher in women (3.2, range 2.7‐3.8) than in men (3.0, range 2.6‐3.5) and increased with age (0.004 per year) (P <.05). The median amplitudes were 35° (range 4‐85) when based on rotation of the capsule and 11 mm (range 6‐31) when based on capsule change in position. The rotation amplitude was higher in women and decreased with increasing BMI (P <.05). The position amplitude was also higher in women and increased with the amount of calories in the test meal, but decreased with increasing BMI and age (P <.05). Day‐to‐day variation (P >.05) was considerable while inter‐rater variability was small. Conclusion and Inferences: We have established normative values for gastric motility assessed with the 3D‐Transit system. [ABSTRACT FROM AUTHOR]

Background: Opioid treatment often causes debilitating constipation. However, it is not well described how opioids affect colonic motility and whether opioid‐induced constipation is due to either a decrease of powerful peristaltic contractions or "uncoordinated" peristalsis. The present study aims to investigate the effect of oxycodone on parameters of colonic motility and to determine whether motility is normalized by the opioid antagonist naloxegol. Methods: In two randomized, double‐blind crossover trials, oxycodone or placebo was administered to 25 healthy males (Trial A), while another 24 healthy males were administered oxycodone with naloxegol or placebo (Trial B). Colonic motility was assessed by tracking the progression of an electromagnetic capsule throughout the large intestine. Segmental colonic transit times and capsule movements were calculated using displacement distance and velocity. Key Results: In Trial A, colonic transit time increased during oxycodone treatment compared with placebo (39 vs 18 hours, P <.01). Displacement during long fast antegrade movements was shorter during oxycodone treatment than with placebo (10 vs 20 cm, P =.03). In Trial B, colonic transit time was faster during oxycodone + naloxegol than during oxycodone + placebo (40 vs 55 hours, P =.049), mainly caused by an increase of the percentwise fraction of distance covered by fast movements in the left colon (P =.001). Conclusion & Inferences: Oxycodone treatment impaired colonic motility, manifested as increased transit time, specifically decreased long fast antegrade movements, and addition of naloxegol improved motility dynamics. In humans, the increased transit time during opioid treatment is caused by a decrease in long fast movements rather than uncoordinated peristalsis. [ABSTRACT FROM AUTHOR]