Abnormal gastrointestinal motility in patients with celiac sprue

Abstract

No study to date has objectively investigated whether the motor behavior of the small bowel is abnormal in celiac sprue. The purpose of this study was to systematically address this topic by means of intraluminal pressure recordings in a series of such patients. Sixteen subjects (nine adults, seven children, age range 2-69 years) with celiac sprue were recruited and studied while untreated. Manometric examination was carried out for 6 hr during fasting and 3 hr after a meal. Adult celiac patients displayed a significantly (mean +/- SEM) greater frequency of migrating motor complexes in comparison to controls during fasting (4.44 +/- 1.6 vs 2.45 +/- 0.20, P < 0.01), whereas no differences were found in the pediatric group with respect to this variable. Fasting motor abnormalities, chiefly represented by discrete clustered contractions, giant jejunal contractions, and bursts of nonpropagated contractions, were discovered in a high percentage in both groups of celiac subjects (89% in adults and 44% in children, respectively). Similar abnormalities were observed in the postprandial period, especially in adults. In conclusion, patients with celiac sprue frequently display discrete gastrointestinal motor abnormalities, which though perhaps nonspecific may account for several symptoms complained of by such patients.

Pulse granuloma, unusual localization: appendix

“…The mechanism for motility disturbances can originate from reduced absorption of food constituents, immunologic reactions or hormonal derangements (6). It has been suggested that intestinal motor abnormalities create hypotonic flaccid bowel loops, which disturb normal peristalsis and cause intussusception without a lead point (7). Delayed short bowel transit time and reduced motility can be responsible for the signs and symptoms of mechanical or pseudoobstruction in children with CD.…”

Esophageal dysfunction in scleroderma. Relationship with disease subsets

“…Gastric and small bowcl motility activity was measured according to a previously described technique and instrumentation (21, 22). An &lumen PVC manometric catheter was used (type ICM 3, outer diameter 4.5 mm, inner diameter for each , and 32 cm from the tip, and was weighted distally with a rubber bag containing 2 ml of mercury.…”

Evaluation Of Esophagitis In Children With Celiac Disease

“…Reflü özofajiti olan çölyak hastalarında glutensiz diyet tedavisi ile belirtilerde gerileme olması, glutenin kas hüc-relerine direkt toksik etkili olduğunu düşündürmüştür (15). Tedavi edilmemiş çölyak hastalarında üst sindirim sisteminin motor bozuklukları gösterilmiştir (7). Özellikle özofagusun manometrik incelemesinde %30 anormal bulgular olduğu gözlenmiştir (16).…”

“…Artmış enteroglukagon ve nörotensinin alt özofageal sfinkter basıncında azalmaya ve mide boşalımında yavaşlama-ya neden olduğu gösterilmiştir (17,18). Erişkin çölyak hastalarında motilite ile ilgili yapılan çalışmalarda; ince bağırsağın manometrik incelemelerinde anormal düzensiz ve dev motor dalgalar saptanmış ve karın ağ-rısı, kronik ishal gibi semptomların bu anormal motiliteye bağlı olabileceği ileri sürülmüştür (7). Diğer çalışmalarda da tedavi edilmemiş çölyak hastalarında mide boşalma zamanında uzama saptanmış ve bulguların glutensiz diyet ile düzeldiği gösterilmiştir (6).…”

“…Tedavisiz çölyak hastalarında, alt özofagus sifinkter basıncında azalma gösterilmiştir. Bununla birlikte çölyak hastalarında reflü özofajit olup olmadı-ğına dair veriler yetersizdir (6,7). Çocuklarda gastroözofageal reflü hastalığı sıklığının %1-8 arasın-da olduğu tahmin edilmektedir.…”