Manometry of the human ileum and ileocaecal junction in health, disease and surgery: A systematic review

Chen Liu, Kai Sheng Saw, Phil G. Dinning, Gregory O’Grady, Ian Bissett

Research output: Contribution to journalReview article

Abstract

Background: The terminal ileum and ileocaecal junction form a transition zone in a relatively inaccessible portion of the gastrointestinal tract. Little is known about themotility of this region with few detailed studies, indicating the need for a robust synthesis of current knowledge. This review aimed to evaluate the quantitative and qualitative data on the manometry findings of the terminal ileum and ileocaecal junction during the fasting and post-prandial periods in healthy individuals and patients with motility disorders or patients after bowel surgery. Methods: A systematic search of five databases (Medline, Pubmed, Embase, Scopus, and Cochrane Library) was performed. Studies that presented manometry data from the human ileum or ileocaecal junction were included. Results: Forty-two studies met the inclusion criteria. The main motility patterns reported in the terminal ileum during fasting were the migrating motor complex, discrete clustered contractions, prolonged propagated contractions and phasic contractions. Post-prandial motility featured irregular, intense contractions. Some studies found a region of sustained increased pressure at the ileocaecal junction while others did not. Patients with motility disorders showed differences inmanometry including retrograde propagation of phase III. Patients post-bowel surgery showed differences including higher incidence of phase III. Conclusion: Motility patterns of the terminal ileum differ between fasting and fed states. Large variability existed in manometry recordings of the terminal ileum. Technical challenges and lack of standardized definitions may reduce accuracy of manometry assessment. Further research is needed to understand how this key portion of the gut physiologically functions.

Original languageEnglish
Article number18
Number of pages16
JournalFrontiers in surgery
Volume7
DOIs
Publication statusPublished - Apr 2020

Bibliographical note

Copyright © 2020 Liu, Saw, Dinning, O’Grady and Bissett. This is an open-access
article distributed under the terms of the Creative Commons Attribution License (CC
BY). The use, distribution or reproduction in other forums is permitted, provided
the original author(s) and the copyright owner(s) are credited and that the original
publication in this journal is cited, in accordance with accepted academic practice.
No use, distribution or reproduction is permitted which does not comply with these
terms.

Keywords

  • Ileocaecal junction
  • Ileum
  • Manometry
  • Motility
  • Small bowel
  • Terminal ileum

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