MRI assessment of the postprandial gastrointestinal motility and peptide response in healthy humans

Background: Feeding triggers inter-related gastrointestinal (GI) motor, peptide and appetite responses. These are rarely studied together due to methodological limitations. Recent MRI advances allow pan-intestinal, non-invasive assessment of motility in the undisturbed gut. This study aimed to develop a methodology to assess pan-intestinal motility and transit in a single session using MRI and compare imaging findings to GI peptide responses to a test meal and symptoms in a healthy volunteer cohort. Methods: Fifteen healthy volunteers (29.3±2.7years and BMI 20.1±1.2Kg/m2) underwent baseline and postprandial MRI scans, symptom questionnaires and blood sampling (for subsequent GI peptide analysis, Glucagon-like peptide-1 (GLP-1), Polypeptide YY (PYY), Cholecystokinin (CCK)) at intervals for 270min following a 400g soup meal (204kcal, Heinz, UK). Gastric volume, gall bladder volume, small bowel water content, small bowel motility and whole gut transit were measured from the MRI scans. Key Results: (mean±SEM) Small bowel motility index increased from fasting 39±3 arbitrary units (a.u.) to a maximum of 87±7a.u. immediately after feeding. PYY increased from fasting 98±10pg/ml to 149±14pg/ml at 30min and GLP-1 from fasting 15±3µg/ml to 22±4µg/ml. CCK increased from fasting 0.40±0.06pmol/ml to 0.94±0.1pmol/ml. Gastric volumes declined with a T1/2 of 46±5min and the gallbladder contracted from a fasting volume of 19±2ml to 12±2ml. Small bowel water content increased from 39±2ml to 51±2ml postprandial. Fullness VAS score increased from 9±5mm to 41±6mm at 30min postprandial. Conclusions and Inferences: The test meal challenge was effective in inducing a change in MRI motility end-points which will improve understanding of the pathophysiological postprandial GI response.