Intestinal Dysmotility in Patients With Functional Digestive Symptoms: Significance of Minute Rythm

Introduction: Intestinal manometry may detect phasic pressure patterns that suggest small bowel obstruction. The most common is the "clustered contractions pattern", characterized by repetitive short spouts of intestinal contractions in the postprandial period. When encountered in patients with chronic unexplained digestive symptoms, an exhaustive radiological evaluation of the gut should be performed to exclude partial mechanical obstruction. If no luminal compromise is identified by the imaging studies, an underlying neuropathic disorder of the bowel may be the probable diagnosis. The objective of this study was to determine the clinical significance of this pattern in patients evaluated for a possible intestinal motility disorder. Study design: Retrospective analysis of the of patients with minute rhythm pattern detected in intestinal manometric recordings performed between 2010 and 2018 at the Vall d'Hebron Digestive Function Unit in consecutive patients referred for evaluation of intestinal motility due to severe, chronic digestive symptoms and suspected dysmotility. The manometric recordings that had been informed of minute rhythm pattern, will be retrieved to confirm the original report. The clinical records of these patients will be reviewed to obtain: a) demographic data, b) digestive symptoms at the time of evaluation, c) history of abdomino-pelvic surgeries or radiotherapy prior to manometry, d) diagnosis of systemic disorders, and e) presence of esophageal, gastric or colonic dysmotility. Results from radiological and other investigations will be also revised, as well as therapeutic decisions and clinical outcome. Particularly, whether abdominal imaging studies (simple abdominal X-ray or abdominal CT scans) were performed within 7 days of the manometric study, and whether these studies showed signs of fecal retention (presence of solid stools in the right colon) or not.