Value of Ultrasonographic Assessment of Sigmoid Colon in the Diagnosis of Irritable Bowel Syndrome

  • Prof Giovanni Maconi, Chair of Gastroenterology – Department of Clinical Sciences – L.Sacco University Hospital, Milan, Italy, Italy
  • Dr Alessandro Massari, Chair of Gastroenterology – Department of Clinical Sciences – L.Sacco University Hospital, Milan, Italy
  • Dr Elisa Radice, Chair of Gastroenterology – Department of Clinical Sciences – L.Sacco University Hospital, Milan, Italy
  • Fulvia Terracciano, U.O. Gastroenterologia, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG, Italy, Italy
  • Prof Gabriele Bianchi Porro, Chair of Gastroenterology – Department of Clinical Sciences – L.Sacco University Hospital, Milan, Italy

    • Background: Ultrasonographic (US) assessment of sigmoid colon has been suggested to identify patients with irritable bowel syndrome (IBS).
    Aim: To evaluate usefulness of US measurement of thickness of muscularis propria of sigmoid colon to identify IBS patients.
    Methods: In 73 consecutive patients (24 M; mean age: 42.6±15.3) referred for abdominal pain (25 patients), alteration in bowel habit (18 patients) or both (30 patients), the thickness of muscularis propria of sigmoid colon was evaluated by high resolution transabdominal US in fasting condition (4 measurements in 3 sections apart). Pain induced by US-guided compression of sigmoid colon and abdomen far from the sigmoid colon was also recorded. Diagnosis of IBS was assessed using Rome II criteria. Patients with organic gastrointestinal disorders, but not diverticulosis, were excluded.
    Results: Rome II-defined IBS was diagnosed in 60 patients (82%). 16 patients had colonic diverticulosis. The thickening of muscularis propria (the mean of 12 measurements) was not statistically significantly different in IBS and non-IBS patients (1.90 vs 1.87 mm). Likewise, difference in score of pain induced by US-guided compression of sigmoid colon and abdomen far form sigmoid colon was similar in IBS and non-IBS patients. The thickening of muscularis propria was significantly correlated with age and differential score of US-induced pain and was also significantly greater in patients with sigmoid diverticulosis.
    Conclusion: The thickening of the muscularis propria of sigmoid colon, measured by US in fasting condition, is not useful to discriminate IBS and non-IBS patients. It may reflect increased age and prefesce of sigmoid diverticulosis.