Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract
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Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract. / Keller, Jutta; Beglinger, Christoph; Holst, Jens Juul; Andresen, Viola; Layer, Peter.
In: American Journal of Physiology: Gastrointestinal and Liver Physiology, Vol. 297, No. 5, 11.2009, p. G861-8.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract
AU - Keller, Jutta
AU - Beglinger, Christoph
AU - Holst, Jens Juul
AU - Andresen, Viola
AU - Layer, Peter
PY - 2009/11
Y1 - 2009/11
N2 - It is unclear why patients with inflammation of the distal bowel complain of symptoms referable to the upper gastrointestinal tract, specifically to gastric emptying (GE) disturbances. Thus we aimed to determine occurrence and putative pathomechanisms of gastric motor disorders in such patients. Thirteen healthy subjects (CON), 13 patients with Crohn's disease (CD), 10 with ulcerative colitis (UC), and 7 with diverticulitis (DIV) underwent a standardized (13)C-octanoic acid gastric emptying breath test. Plasma glucose, CCK, peptide YY, and glucagon-like peptide-1 (GLP-1) were measured periodically and correlated with GE parameters. Results were given in means +/- SD. Compared with CON, GE half time (T) was prolonged by 50% in CD (115 +/- 55 vs. 182 +/- 95 min, P = 0.037). Six CD, 2 DIV, and 2 UC patients had pathological T (>200 min). Postprandial plasma glucose was increased in all patients but was highest in DIV and correlated with T (r = 0.90, P = 0.006). In CD, mean postprandial CCK levels were increased threefold compared with CON (6.5 +/- 6.7 vs. 2.1 +/- 0.6 pmol/l, P = 0.027) and were correlated with T (r = 0.60, P = 0.041). Compared with CON, GLP-1 levels were increased in UC (25.1 +/- 5.2 vs. 33.5 +/- 13.0 pmol/l, P = 0.046) but markedly decreased in DIV (9.6 +/- 5.2 pmol/l, P < 0.0001). We concluded that a subset of patients with CD, UC, or DIV has delayed GE. GE disturbances are most pronounced in CD and might partly be caused by excessive CCK release. In DIV there might be a pathophysiological link between decreased GLP-1 release, postprandial hyperglycemia, and delayed GE. These explorative data encourage further studies in larger patient groups.
AB - It is unclear why patients with inflammation of the distal bowel complain of symptoms referable to the upper gastrointestinal tract, specifically to gastric emptying (GE) disturbances. Thus we aimed to determine occurrence and putative pathomechanisms of gastric motor disorders in such patients. Thirteen healthy subjects (CON), 13 patients with Crohn's disease (CD), 10 with ulcerative colitis (UC), and 7 with diverticulitis (DIV) underwent a standardized (13)C-octanoic acid gastric emptying breath test. Plasma glucose, CCK, peptide YY, and glucagon-like peptide-1 (GLP-1) were measured periodically and correlated with GE parameters. Results were given in means +/- SD. Compared with CON, GE half time (T) was prolonged by 50% in CD (115 +/- 55 vs. 182 +/- 95 min, P = 0.037). Six CD, 2 DIV, and 2 UC patients had pathological T (>200 min). Postprandial plasma glucose was increased in all patients but was highest in DIV and correlated with T (r = 0.90, P = 0.006). In CD, mean postprandial CCK levels were increased threefold compared with CON (6.5 +/- 6.7 vs. 2.1 +/- 0.6 pmol/l, P = 0.027) and were correlated with T (r = 0.60, P = 0.041). Compared with CON, GLP-1 levels were increased in UC (25.1 +/- 5.2 vs. 33.5 +/- 13.0 pmol/l, P = 0.046) but markedly decreased in DIV (9.6 +/- 5.2 pmol/l, P < 0.0001). We concluded that a subset of patients with CD, UC, or DIV has delayed GE. GE disturbances are most pronounced in CD and might partly be caused by excessive CCK release. In DIV there might be a pathophysiological link between decreased GLP-1 release, postprandial hyperglycemia, and delayed GE. These explorative data encourage further studies in larger patient groups.
KW - Acute Disease
KW - Adult
KW - Aged
KW - Blood Glucose
KW - C-Reactive Protein
KW - Cholecystokinin
KW - Chronic Disease
KW - Colitis, Ulcerative
KW - Crohn Disease
KW - Diverticulitis, Colonic
KW - Fasting
KW - Female
KW - Gastric Emptying
KW - Gastrointestinal Diseases
KW - Glucagon-Like Peptide 1
KW - Humans
KW - Male
KW - Middle Aged
KW - Peptide YY
KW - Postprandial Period
KW - Steroids
KW - Young Adult
M3 - Journal article
C2 - 20501434
VL - 297
SP - G861-8
JO - American Journal of Physiology: Gastrointestinal and Liver Physiology
JF - American Journal of Physiology: Gastrointestinal and Liver Physiology
SN - 0193-1857
IS - 5
ER -
ID: 132048011