title: Delayed small bowel transit in children with cystic fibrosis and pancreatic insufficiency.
abstract: OBJECTIVE
  Gastrointestinal disturbances are common in people with cystic fibrosis (CF); however, motility studies in this population have yielded inconsistent results. This study examined gastric emptying (GE) and small bowel transit (SBT) time in children with CF and pancreatic insufficiency compared with a healthy adult reference group.
  
  
  METHODS
  Participants consumed an 8-ounce liquid test meal (approximately 550 calories, 32 g of fat) labeled with 300 μCi 99m technetium (Tc) sulfur colloid. Subjects with CF received a standard dose of pancreatic enzymes before consuming the test meal. GE and SBT were measured using a standard nuclear medicine scan. GE was determined after correcting for 99mTc decay in both anterior and posterior images. SBT was determined by following the movement of the tracer from the stomach to the cecum. The percentage arrival of total small bowel activity at the terminal ileum and cecum/ascending colon at 6 hours was used as an index of SBT. A 1-way analysis of covariance was performed for comparisons between groups after adjustment for age, sex, and body mass index.
  
  
  RESULTS
  Subjects with CF (n = 16) had similar GE compared with the healthy reference group (n = 12); however, subjects with CF had significantly prolonged SBT time. At 6 hours, 37.2% ± 25.4% (95% CI 23.7-50.7) of the tracer reached the terminal ileum and colon compared with 68.6% ± 13.1% (95% CI 60.2-76.9) for the reference group (P < 0.001). After controlling for sex, age, and body mass index, this difference remained statistically significant (F = 12.06, adjusted R = 0.44, P < 0.002).
  
  
  CONCLUSIONS
  Children with CF and pancreatic insufficiency had unaltered GE but delayed SBT time when taking pancreatic enzymes.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
authors.forename: Alisha J
authors.initials: AJ
authors.lastname: Rovner
authors.forename: Joan I
authors.initials: JI
authors.lastname: Schall
authors.forename: John T
authors.initials: JT
authors.lastname: Mondick
authors.forename: Hongming
authors.initials: H
authors.lastname: Zhuang
authors.forename: Maria R
authors.initials: MR
authors.lastname: Mascarenhas
mesh_terms: D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000503:physiopathology*; D019587:Dietary Supplements; D056947:Enzyme Replacement Therapy; D010188:Exocrine Pancreatic Insufficiency / Q000178:diet therapy / Q000209:etiology*; D005260:Female; D005769:Gastrointestinal Motility; D005772:Gastrointestinal Transit; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000209:etiology*; D007421:Intestine, Small / Q000503:physiopathology*; D008297:Male; D020799:Pancrelipase / Q000627:therapeutic use; D019518:Postprandial Period; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D020799:Pancrelipase; D013671:Technetium Tc 99m Sulfur Colloid