Quantitative analysis of bowel gas using plain abdominal radiograph in patients with irritable bowel syndrome.
OBJECTIVE
Ideally, the diagnosis of irritable bowel syndrome (IBS) would be achieved using a minimal number of procedures. It is presumed that bowel gas is related to IBS, and it is easily visualized by plain abdominal radiograph. In the present study, to clarify the relationship between IBS and the quantity of bowel gas, the measured bowel gas volume using plain abdominal radiographs was compared with the pathology of IBS.


METHODS
Plain abdominal radiographs were digitized and transmitted to a computer (computed radiography) in 30 IBS patients and 30 normal controls. The quantity of bowel gas, determined as the pixel value on images and standardized by physique, was defined as the gas volume score (GVS). Using the mean +/- 2SD of GVS in the control group as the normal score, IBS patients were divided into three groups: high, normal, and low. To examine the sequential reproducibility of a similar quantity of bowel gas, a second plain abdominal radiography was performed about 2 months later, and the GVS were compared. The colonic transit time was determined using radiopaque markers.


RESULTS
There was a strong correlation between the quantities of bowel gas measured by two independent gastroenterologists. The mean GVS of IBS patients was significantly higher than that in the control group (p < 0.001). The sequential reproducibility was recognized in all 10 IBS patients. There was no significance between colonic transit time and GVS, nor between symptoms and GVS.


CONCLUSIONS
Abdominal gas was analyzed objectively by using GVS, and GVS was considered to represent a useful tool for the diagnosis of IBS.
First Department of Medicine, Chiba University School of Medicine, Japan.
A
A
Koide
T
T
Yamaguchi
T
T
Odaka
H
H
Koyama
T
T
Tsuyuguchi
H
H
Kitahara
M
M
Ohto
H
H
Saisho
D000328:Adult; D000368:Aged; D003109:Colonic Diseases, Functional / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D005414:Flatulence / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results