Comparison of the composition of faecal fluid in Crohn's disease and ulcerative colitis.

Abstract

SUMMARY We determined the ionic composition of faecal fluid from 13 patients with Crohn's disease limited to the colon, 10 with diffuse ulcerative colitis, and eight with ulcerative proctitis. The Crohn's and colitis groups had similar proportions of colon surface involved radiographically and similar 24 hour faecal weights. However, Crohn's patients' faecal fluid had arithmetically lower mean sodium and statistically lower mean chloride (34.8 mmol/l ± 16.2 SD vs. 53.1 mmol/l ± 23.1 SD) and higher potassium (49.2 mmol/l ± 20.2 SD vs. 33.0 mmol/l ± 13.8 SD) concentrations (p < 0.05 for each) and much higher osmolality (487.1 mOsmol/kg ± 87.1 SD vs. 341.1 mOsmol/ kg ± 88.9 SD, P < 0.001). Separation of these patients using the faecal osmotic gap agreed with the clinical classification in 86% of cases. The diarrhoea of proctitis patients had a nearly normal ionic composition which was clearly distinguishable from that of diffuse colitis. These results suggest differences in the composition and perhaps the pathogenesis of the diarrhoea of Crohn's and ulcerative colitis. The composition of fluid may prove a useful, non-invasive method for classifying patients with inflammatory bowel disease and, in ulcerative colitis, determining the extent of the inflammatory process.

Protein Kinase R Mediates the Inflammatory Response Induced by Hyperosmotic Stress

“…It was discovered long ago that colonic fluids in patients diagnosed with IBD have higher osmolarity and ionic content (12,13). It has been previously hypothesized that DSS contributes to induction of colitis via a hyperosmotic stress response (50,53).…”

“…It has been shown previously that proinflammatory gene and cytokine induction, as well as invasion of immune cells, is observed in tissues susceptible to hyperosmotic changes in the extracellular environment, such as the kidney (7), cornea, liver, and gastrointestinal tract (8). Several inflammatory diseases have been linked to a hyperosmotic stress response, such as diabetes (9), dry eye syndrome (10,11), and inflammatory bowel disease (IBD) (12,13).…”

c-Jun NH2-terminal kinase-2 mediates osmotic stress-induced tight junction disruption in the intestinal epithelium

“…Osmotic stress is one type of stress that the intestine faces under physiological (12) and pathophysiological (5,19,24) conditions. The mechanism associated with stress-induced perturbation of intestinal mucosal homeostasis is not well understood.…”

Inhibitory phosphorylation of GSK-3β by AKT, PKA, and PI3K contributes to high NaCl-induced activation of the transcription factor NFAT5 (TonEBP/OREBP)

“…Cells in various organs such as thymus and spleen (23), intervertebral discs (37), and, most notably, the kidney medulla (14) are normally exposed to a hyperosmotic environment. Cells in general also are impacted by the hyperosmolality of hypernatremia (49), diabetes mellitus (6), and inflammatory bowel disease (59) and in other conditions (46). Based on the present study, further analysis of the role of GSK-3␤ may help to understand how cells cope with the hyperosmotic stress associated with these various physiological and pathophysiological conditions.…”