Introduction
In patients with chronic constipation, slow colonic transit is hypothesised to be associated with altered colonic fermentation profiles. Green kiwifruit is known to have laxative effects. This could be caused by the modulation of colonic microbiota, which has a role in regulating colonic transit1. The wireless motility capsule measures gastrointestinal anatomical landmarks through changes in pH and temperature, while a novel gas-sensing capsule measures anatomical landmarks and colonic fermentation2,3. In this study, both technologies were used to investigate the effects of green kiwifruit on gastrointestinal transit and colonic fermentation profiles in participants with constipation.
Aims & Methods
Participants with chronic constipation (N = 62) were randomised to consume two green kiwifruit (Actinidia deliciosa, ~150g per serving, ~90 kcal) or
calorie-matched maltodextrin (~90 kcal = 25g) daily for four weeks. A subset of the participants (N = 21) consumed a standardised breakfast and ingested the wireless motility capsule or both wireless motility devices (wireless motility capsule and gas-sensing capsule) at baseline and post-intervention. Participants fasted six hours post-ingestion and wore data receivers until device excretion.
Results
Preliminary blinded results show that the wireless motility capsule measured colonic transit time decreased in participants on intervention A (median decrease = 1.4 hours, interquartile range (IQR) (-32.00, 9.12)) and increased on intervention B (median increase = 15.8 hours, IQR (-46.89, 23.48)), the change in colonic transit time was not significant (p = 0.628). There was no significant difference between the median colonic H2 and CO2 (% concentration/hour) at baseline and post-intervention (H2: p = 0.50; CO2: p =0.138). The difference between interventions was not significant for median colonic H2 and CO2 concentrations (H2: p = 0.200; CO2: p =0.800).
Conclusion
The wireless motility capsule and the gas-sensing capsule technologies assessed the differences in colonic transit time after dietary intervention. The gas-sensing capsule measured the colonic gas profile accurately and safely. The gas-sensing capsule has the potential to be used as a tool for measuring colonic fermentation profile. Despite encouraging results, this study had several limitations, including a small sample size, unusable data due to data loss, and transit time beyond the battery life of the capsules. Further analyses will explore the relationship of colonic gas concentration with colonic transit time and faecal microbiota.
References
1. Bayer, S. B., Gearry, R. B., & Drummond, L. N. (2018). Putative mechanisms of kiwifruit on maintenance of normal gastrointestinal function. Crit Rev Food Sci Nutr, 58(14), 2432-2452. https://doi.org/10.1080/10408398.2017.1327841
2. So, D., Yao, C. K., Ardalan, Z. S., Thwaites, P. A., Kalantar-Zadeh, K., Gibson, P. R., & Muir, J. G. (2022). Supplementing Dietary Fibers With a Low FODMAP Diet in Irritable Bowel Syndrome: A Randomized Controlled Crossover Trial. Clinical Gastroenterology & Hepatology, 20(9), 2112-2120.e2117. https://doi.org/10.1016/j.cgh.2021.12.016
3. Thwaites, P. A., Yao, C. K., Maggo, J., John, J., Chrimes, A. F., Burgell, R. E., Muir, J. G., Parker, F. C., So, D., Kalantar-Zadeh, K., Gearry, R. B., Berean, K. J., & Gibson, P. R. (2022). Comparison of gastrointestinal landmarks using the gas-sensing capsule and wireless motility capsule. Alimentary Pharmacology & Therapeutics, 56(9), 1337-1348. https://doi.org/10.1111/apt.17216
Disclosure
Jasjot Maggo and Hwei Ng - Received research support from Atmo Biosciences.
Simone Bayer - Received funding for project, travel and conference from Zespri™ International Ltd.
Nicole Roy - Received funding from Zespri™ International Ltd.
Richard Gearry - Received research funding from Atmo Biosciences and Zespri™ International Ltd. He is an advisory board member for Zespri™ International Ltd. He has received support for travel or educational planning/attendance at conferences from Zespri™ International Ltd.
