Imaging in pediatric disorders of the gut-brain interactions: current best practice and future directions

ABSTRACT

Introduction

Disorders of Gut-Brain Interactions (DGBI) are a common clinical problem in children and pose significant challenges to the attending pediatrician. Radiological investigations are commonly ordered to evaluate these children.

Area covered

This review focuses on the current best practice of using radiological investigations in DGBIs and how novel radiological investigations could revolutionize the assessment and therapeutic approach of DGBI in children.

Expert opinion

We believe imaging in DGBI is still in its early stages, but it has the potential to revolutionize how we diagnose and treat children with DGBI. As the understanding of the gut-brain axis continues to grow, we can expect to see the disappearance of conventional imaging techniques and the emergence of more sophisticated imaging techniques with less radiation exposure in the future which provide more clinically meaningful information regarding the gut-brain axis and its influence on intestinal function. Some of the novel imaging modalities will be able to broaden our horizon of understanding DGBI in children providing more useful therapeutic options to minimize their suffering.

KEYWORDS:

• Disorders of gut-brain interactions
• functional gastrointestinal disorders
• constipation
• irritable bowel syndrome
• functional abdominal pain
• abdominal X-ray
• abdominal ultrasound
• functional MRI

Article highlights

• Although commonly used plain abdominal radiograph has a minimal value in evaluating children with DGBI, especially functional abdominal pain, and functional constipation

• Conventional ultrasonography does not provide valuable information in diagnosing DGBI. However, novel uses such as ultrasonographic gastric emptying measurement and evaluation of rectal diameter in children with functional constipation have promising future

• MRI-based evaluation of gastrointestinal motility and fMRI techniques to evaluate the central nervous system and gut-brain interactions have promising futures for improving our understanding of DGBI.

• Novel imaging techniques such as magnetic resonance spectroscopy, multimodal imaging, and personalized imaging will provide a more detailed understanding of the gut-brain axis and will be the future of imaging in the evaluation of children with DGBI.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.