Digestion

van de Merwe, J.P.; Mol, G.J.J.

doi: 10.1159/000198767pmid: 7128947

Fecal levels of trypsin and α-chymotrypsin in patients with Crohn’s disease (CD) were compared with those in healthy subjects. About one-third of the patients with CD had higher levels of trypsin and α-chymotrypsin than the healthy subjects studied. Patients in whom the ileum was affected had higher median values than those in whom the disease was confined to the colon. Possible consequences of high levels of proteolytic enzymes in feces of patients with CD are discussed.

Vagne, M.; Gelin, M.L.; McDonald, T.J.; Chayvialle, J.A.; Minaire, Y.

doi: 10.1159/000198768pmid: 6813168

The effect of bombesin on acid and pepsin secretion and antral motility was compared to that of pentagastrin in conscious cats. Bombesin stimulated acid secretion to 65 % of the maximal response to pentagastrin but induced a stronger pepsin secretion than any dose of pentagastrin. As to antral motility, bombesin first induced an effect comparable to that of pentagastrin, with an increase of low-amplitude and a decrease of high-amplitude contractions. After about 30 min of continuous infusion, the effect of bombesin changed with a return to basal frequency for the low-amplitude contractions and an increase of high-amplitude contractions. This effect was not observed with pentagastrin nor cholecystokinin and was not explained by the variations of plasma insulin concentration.

Baldi, F.; Ferrarini, F.; Corinaldesi, R.; Balestra, R.; Cassan, M.; Fenati, G.P.; Barbara, L.

doi: 10.1159/000198769pmid: 7128948

Anal manometry was performed in 8 control individuals (group A) and in 13 patients with idiopathic constipation (group B), 6 of whom were grouped apart (group C) because of an elective delay of the intestinal transit in the rectum. The basal pressure of the internal anal sphincter, the rectal inflation volume necessary to elicit the rectoanal inhibitory reflex, and the duration of the reflex were not significantly different in the three groups, while the maximal amplitude of the reflex was significantly lower in group C at 10 and 100 cm³ of rectal distension. However, the amplitude of the sphincteric relaxation and the rectal inflation volumes were significantly correlated (p < 0.001) in the three groups. The rectal sensitivity was lower in the patient groups and particularly in group C (p < 0.05 vs. controls up to 50 cm³ of rectal distension). The results obtained do not support the Outlet obstruction’ hypothesis as a mechanism of idiopathic constipation and point out that rectal hyposensitivity seems to be the only abnormality in these patients, particularly in those with an elective delay of the transit in the rectum.

Vantini, I.; Piubello, W.; Scuro, L.A.; Benini, P.; Talamini, G.; Benini, L.; Micciolo, R.; Cavallini, G.

doi: 10.1159/000198770pmid: 7128949

Frequency of duodenal ulcer in patients with chronic pancreatitis is still controversial. This study aims to prospectively investigate the frequency of duodenal ulcer in a group of 190 patients (162 males and 28 females) affected by chronic relapsing pancreatitis admitted to our department between 1970 and 1979. 41 cases (21.5%) were endoscopically observed (22% of the males and 17.9% of the females; male:female ratio 1.2:1). Drinking habits, cigarette consumption, presence of pancreatic calcifications and surgery did not affect the frequency of duodenal ulcer. Exocrine pancreatic insufficiency, as fecal fat excretion higher than 7 g/day, seems to be linked with an increased frequency of duodenal ulcer (exact Fisher’s test: p = 0.0586). Moreover, duodenal ulcer was present in about one third of the patients who afterwards died, but it was the cause of death in only 1 case. Even if a prospective control population is lacking, the male:female ratio of duodenal ulcer in chronic pancreatitis seems to be different from that observed in a comparable hospitalized group (1.2:1 vs. 2.4:1) and from that reported in literature in the general adult population.

Blom, Håkan

doi: 10.1159/000198771pmid: 7128950

Ulcers were produced in the gastric mucosa in rats. After 90 days of healing, one group of animals was given pentagastrin and carbacholine via continuous subcutaneous infusion. After 1 h the animals were killed and the wounds and normal mucosa beside the wounds were prepared for electron microscopy. Stereological analyses of regenerating parietal cells from the wounds revealed that stimulation by the secretagogues increased the secretory surface density by some 76%. pH studies were performed in the wounds in another group of animals after the same stimulation as above, and it was found that the secretory product was acid. Thus, immature parietal cells in healing gastric wounds reacted normally to the secretagogues given and they were able to secrete HCl.

Takasugi, Sumiyoshi; Yonezawa, Hidetoshi; Ikei, Nobuhiro; Kanno, Tomio

doi: 10.1159/000198772pmid: 6182046

Acute hemorrhagic pancreatitis was induced in rats and dogs by a closed duodenal loop method. All dogs and most of the rats died of acute pancreatitis within 18 h after the operation. Infusion of a synthetic trypsin inhibitor into the lumen of the closed duodenal loop not only prevented development of acute pancreatitis in these animals, but they survived without any acute signs of the disease. As elevation of amylase activity in the pancreata of rats and in the plasma of dogs is not always associated with the development of acute pancreatitis, esterolytic activity may thus be a superior index of this entity.

Segal, Isidor; Walker, Alexander R.P.

doi: 10.1159/000198773pmid: 6813167

At Baragwanath Hospital, Johannesburg, South Africa, during a 3-year period diverticular disease was diagnosed in 42 Black patients (16 men, 26 women), from an urban population approaching 1,5 million. Patients presented mainly with rectal bleeding, abdominal mass or pain. Of average age 62 years, all were among the more privileged. The persisting very low frequency of the disease, which is in consonance with low frequencies of other bowel diseases (appendicitis, ulcerative colitis, colon cancer), is deemed valid. The mean daily dietary fibre intake, 26.5 ± 8.5 g, was higher than that of local Whites, 22.4 ± 6.0 g, but significantly less than that of a sex-age matched urban Black control group, 32.5 ± 11.4 g. Although a measure of westernization of diet has obviously occurred, its extent, also the period of exposure, would seem to have been insufficient to have evoked significant rises in the occurrence of diverticular disease.

Nassar, Camille F.; Haddad, Mary E.; Khuri, Raja N.

doi: 10.1159/000198774pmid: 6290300

The uptake of prostaglandin E₁ by rat intestine mucosal strips was investigated. The results indicate that: (1) PGE₁ did not accumulate in the epithelial cells of rat intestine. The intracellular to extracellular distribution ratio did not reach unity in spite of the extended periods of incubation. (2) A decrease in the sodium gradient across the brush-border membrane of intestinal cells significantly inhibited PGE₁ uptake by the mucosal strips. (3) PGE₁uptake increases with increasing concentration of potassium in the incubation medium with a tendency for saturation at high K⁺ levels. (4) Calcium and magnesium ions had no effect on the steady-state uptake of PGE₁ by the epithelial cells of rat intestine. (5) Addition of sodium carbonate or phosphate to the incubation medium significantly decreased PGE₁ uptake by the intestinal cells. (6) Further studies of PGE₁ uptake reveal a temperature-dependent process with a Q₁₀ of 2.8.

Isaksson, G.; Lundquist, I.; Ihse, I.

doi: 10.1159/000198775pmid: 6290301

Trypsin, amylase, lipase and phospholipase activities were assayed in buffer solutions and in human duodenal juice after incubation with different types of dietary fiber. In buffer solutions, trypsin activity was slightly reduced and amylase activity heavily reduced by pectin of low methylic esterification (LM pectin). Lipase activity was markedly reduced by LM pectin and also moderately reduced by pectin of high methylic esterification (HM pectin). Phospholipase was hardly influenced at all by fiber. Activities of pancreatic enzymes in human duodenal juice were examined after in vitro incubation with pectins, guar gum, wheat bran and ispaghula. Ispaghula did not affect the enzymes except for lipase activity, which was moderately inhibited. The other fiber preparations examined reduced amylase activity by 35–100% at fiber concentrations of up to 1.5 g%, lipase by 40–95% and trypsin by 40–85%. LM pectin had the strongest inhibitory effect among the different fiber preparations studied. Phospholipase activity was only influenced by the pectins, which caused a 75 % reduction. It is concluded that dietary fiber of different kinds has the capacity to inhibit pancreatic enzyme activities. This inhibitory effect is dependent on the type of fiber and differently affects the different enzymes. Further, the inhibition seems to be more pronounced when exerted in human duodenal juice than in conventional buffer systems.

Morgan, R.J.; Nelson, L.M.; Russell, R.I.; Main, A.N.H.; Hall, M.J.

doi: 10.1159/000198776pmid: 7128951

There is evidence in favour of Crohn’s disease being a diffuse lesion of the gut, and we have studied this by investigating small intestinal absorptive function in a series of 9 patients with Crohn’s disease, who had no histological or radiological evidence of jejunal involvement, and 9 normal control subjects. Using a triple lumen tube perfusion system we found no significant differences in the absorption of folic acid, water and electrolytes between the patients and controls. This study shows that absorptive function is preserved in the apparently normal proximal jejunal mucosa of patients with Crohn’s disease, and does not lend support to the concept of a functional diffuse lesion.