Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns.

Abstract

SUMMARYThe time taken for a solid meal to pass through the stomach, small intestine, and colon was measured in 61 patients with irritable bowel syndrome, subdivided according to their presenting symptoms, and in 53 healthy volunteers. Small bowel transit times were significantly shorter in patients who complained predominiantly of diarrhoea (3.3±0.3 vs 4.2±0.2 h; p=001; n=21) and significantly longer in patients who complained predominantly of constipation (5.4±0.3 vs 4.2±0.2 h; p<001; n=23) or pain and distension (5.4±0.4 vs 4.2±0.2 h; p<001; n= 17) compared with controls. Whole gut transit times were shorter in patients who complained of diarrhoea (35±5 vs 53±4 h; p<0.01), and longer in patients with constipation (87±13 vs 53±4 h; p<005) compared with controls. No significant differences in gastric emptying rates were shown between any of the patient groups and normal controls. Thirty-four patients reported pain, particularly in the right iliac fossa, during the meal transit test, and in 25 of these (74%), the onset of the pain was associated with the arrival of residues of the test meal in the caecum. Our results indicate that irritable bowel syndrome intestine as well as the colon.

Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome a double-blind, randomized, placebo-controlled study

“…Studies have suggested that small bowel transit is accelerated in diarrhea-predominant IBS (22)(23)(24). Similar studies suggest that subjects with constipation-predominant IBS have delayed transit (22,23). If transit is the explanation for the abnormal breath test findings, then subjects with constipation-predominant IBS should have delayed gas rise on breath test compared with subjects with diarrhea.…”

“…Because it is suggested in the literature that diarrheapredominant IBS is associated with rapid transit (22)(23)(24) and constipation predominant IBS with slow transit (22,23), the hydrogen profile should be different in both groups.…”

Mild dehydration: a risk factor of constipation?

“…A lower bowel frequency indicates constipation and was observed in 1 and 5% of a healthy British and American population, respectively (Read & Timms, 1986). In healthy subjects fed a normal mixed diet, the daily stool output varies between 50 and about 400 g. The mean value was significantly lower in women 149 and 112 g than in men, 229 and 166 g, respectively (Po0.001 and o0.05) (Cann et al, 1983;Davies et al, 1986). As 90% of the total gut transit time of food residue takes place in the colon, the use of ingested markers is an accurate measurement of colonic transit (Read & Timms, 1986).…”

Bloating and functional gastro-intestinal disorders: Where are we and where are we going?

“…Even if intestinal motility since long is recognized as one of the key features in functional bowel disorders pathophysiology [73] , its central role can be questioned when it comes to bloating generation using conventional techniques [74] . A recent study has also suggested that altered colon transit correlates poorly or not at all with IBS symptoms such as bloating, flatulence or pain [75] .…”