Document Detail

Postprandial changes in small bowel water content in healthy subjects and patients with irritable bowel syndrome.
MedLine Citation:
PMID:  19909743     Owner:  NLM     Status:  MEDLINE    
BACKGROUND & AIMS: Postprandial symptoms are common in patients with irritable bowel syndrome with diarrhea (IBS-D) and could be diet related. We studied postprandial changes in distribution of water in the upper gastrointestinal tract of healthy volunteers (HVs) and patients with IBS-D after contrasting meals. METHODS: In study 1, 11 HVs consumed 350-mL test meals with 5% mannitol (unabsorbable) or 5% glucose (readily absorbed). In study 2, 17 HVs consumed a 331-kcal meal, with or without 15 g bran. In study 3, 26 patients with IBS-D consumed the study 2 diet with bran meal. All subjects underwent serial magnetic resonance imaging analysis. RESULTS: In study 1, subjects' small bowel water content (SBWC) increased after the mannitol but not glucose meals, reaching 381 mL (interquartile range, 343-491 mL) and 47 mL (18-78 mL), respectively, 40 minutes after eating (P < .001). In study 2, SBWC initially decreased after both meal types and then increased, plateauing at 180-405 minutes and was greater after the bran meal (P = .02). In study 3, fasting and postprandial SBWC was lower in IBS-D than in HVs (P < .05 and P < .0001, respectively). Patients with IBS-D had faster orocecal transit times (135 minutes; 90-180 minutes) compared with HVs (225 minutes; 203-293 minutes; P < .0001) and reduced terminal ileum diameter (P < .003). CONCLUSIONS: Postprandial SBWC initially decreases, because of rapid, nutrient-driven fluid absorption, and then increases after a mixed liquid/solid meal. Patients with IBS-D have reduced fasting and postprandial SBWC with faster transit, possibly indicating increased small intestinal tone.
Luca Marciani; Eleanor F Cox; Caroline L Hoad; Susan Pritchard; John J Totman; Steve Foley; Amisha Mistry; Steven Evans; Penny A Gowland; Robin C Spiller
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-11-10
Journal Detail:
Title:  Gastroenterology     Volume:  138     ISSN:  1528-0012     ISO Abbreviation:  Gastroenterology     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-04-01     Revised Date:  2010-09-10    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  469-77, 477.e1     Citation Subset:  AIM; IM    
Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, University of Nottingham, Nottingham, United Kingdom.
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MeSH Terms
Cross-Over Studies
Dietary Fiber / metabolism
Gastrointestinal Motility / physiology
Glucose / metabolism
Intestinal Absorption / physiology*
Intestine, Small / metabolism*
Irritable Bowel Syndrome / physiopathology*
Magnetic Resonance Imaging
Mannitol / metabolism
Middle Aged
Postprandial Period / physiology*
Water / metabolism*
Reg. No./Substance:
50-99-7/Glucose; 69-65-8/Mannitol; 7732-18-5/Water
Comment In:
Curr Gastroenterol Rep. 2010 Oct;12(5):305-6   [PMID:  20711865 ]

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