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. 1989 Jan;30(1):26–29. doi: 10.1136/gut.30.1.26

Orocaecal transit time in health and in thyroid disease.

M V Tobin 1, R A Fisken 1, R T Diggory 1, A I Morris 1, I T Gilmore 1
PMCID: PMC1378225  PMID: 2920922

Abstract

Altered bowel habit commonly occurs in thyroid disease. We measured orocaecal transit in healthy volunteers and in hyperthyroid and hypothyroid patients before and after treatment, using the lactulose hydrogen breath test incorporating a standard liquid meal to obtain a more physiological assessment. Mean transit time in 12 control subjects was 85 (8) minutes (mean (SE)) (mean coefficient of variation between replicate studies, 8.6% (3%)). In eighteen hyperthyroid patients transit was more rapid at 49 (4) minutes (p less than 0.01). Ten hypothyroid patients had a transit time similar to controls at 91 (9) minutes. Transit time returned to normal in thyrotoxic patients after treatment but in eight hypothyroid patients retested, it remained unchanged. Our findings suggest that (a) the inclusion of a liquid meal provides a reproducible method of measuring orocaecal transit using the lactulose hydrogen breath test, (b) rapid small bowel transit in thyrotoxicosis may be one factor in the diarrhoea which is a feature of the disease and (c) if altered gut transit is the cause of sluggish bowel habit in hypothyroidism, delay in the colon, and not small bowel, is likely to be responsible.

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Selected References

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  1. Abbasi A. A., Douglass R. C., Bissell G. W., Chen Y. Myxedema ileus. A form of intestinal pseudo-obstruction. JAMA. 1975 Oct 13;234(2):181–183. doi: 10.1001/jama.234.2.181. [DOI] [PubMed] [Google Scholar]
  2. Bond J. H., Jr, Levitt M. D., Prentiss R. Investigation of small bowel transit time in man utilizing pulmonary hydrogen (H2) measurements. J Lab Clin Med. 1975 Apr;85(4):546–555. [PubMed] [Google Scholar]
  3. Boruchow I. B., Miller L. D., Fitts W. T., Jr Paralytic ileus in myxedema. Arch Surg. 1966 Jun;92(6):960–963. doi: 10.1001/archsurg.1966.01320240148033. [DOI] [PubMed] [Google Scholar]
  4. CHAPMAN E. M., MALOOF F. Bizarre clinical manifestations of hyperthyroidism. N Engl J Med. 1956 Jan 5;254(1):1–5. doi: 10.1056/NEJM195601052540101. [DOI] [PubMed] [Google Scholar]
  5. Corbett C. L., Thomas S., Read N. W., Hobson N., Bergman I., Holdsworth C. D. Electrochemical detector for breath hydrogen determination: measurement of small bowel transit time in normal subjects and patients with the irritable bowel syndrome. Gut. 1981 Oct;22(10):836–840. doi: 10.1136/gut.22.10.836. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dotevall G., Walan A. Gastric secretion of acid and intrinsic factor in patients with hyper- and hypothyroidism. Acta Med Scand. 1969 Dec;186(6):529–533. doi: 10.1111/j.0954-6820.1969.tb01517.x. [DOI] [PubMed] [Google Scholar]
  7. Duret R. L., Bastenie P. A. Intestinal disorders in hypothyroidism. Clinical and manometric study. Am J Dig Dis. 1971 Aug;16(8):723–727. doi: 10.1007/BF02239597. [DOI] [PubMed] [Google Scholar]
  8. HOHL R. D., NIXON R. K. MYXEDEMA ILEUS. Arch Intern Med. 1965 Feb;115:145–150. doi: 10.1001/archinte.1965.03860140025006. [DOI] [PubMed] [Google Scholar]
  9. Hellesen C., Friis T., Larsen E., Pock-Steen C. Small intestinal histology, radiology and absorption in hyperthyroidism. Scand J Gastroenterol. 1969;4(2):169–175. doi: 10.3109/00365526909179925. [DOI] [PubMed] [Google Scholar]
  10. KELLEY M. L., Jr, STEWART J. M. MYXEDEMA AND INTESTINAL MALABSORPTION (NONTROPICAL SPRUE?) WITH SEVERE HYPOMOTILITY OF THE GASTROINTESTINAL TRACT: REPORT OF A CASE. Am J Dig Dis. 1964 Jan;9:79–86. doi: 10.1007/BF02232684. [DOI] [PubMed] [Google Scholar]
  11. Kim S. K. Small intestine transit time in the normal small bowel study. Am J Roentgenol Radium Ther Nucl Med. 1968 Nov;104(3):522–524. doi: 10.2214/ajr.104.3.522. [DOI] [PubMed] [Google Scholar]
  12. La Brooy S. J., Male P. J., Beavis A. K., Misiewicz J. J. Assessment of the reproducibility of the lactulose H2 breath test as a measure of mouth to caecum transit time. Gut. 1983 Oct;24(10):893–896. doi: 10.1136/gut.24.10.893. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Metz G., Gassull M. A., Leeds A. R., Blendis L. M., Jenkins D. J. A simple method of measuring breath hydrogen in carbohydrate malabsorption by end-expiratory sampling. Clin Sci Mol Med. 1976 Mar;50(3):237–240. doi: 10.1042/cs0500237. [DOI] [PubMed] [Google Scholar]
  14. Middleton W. R., Thompson G. R. Steatorrhoea in hyperthyroidism. Gut. 1968 Dec;9(6):725–726. [PubMed] [Google Scholar]
  15. Middleton W. R. Thyroid hormones and the gut. Gut. 1971 Feb;12(2):172–177. doi: 10.1136/gut.12.2.172. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Miller L. J., Gorman C. A., Go V. L. Gut-thyroid interrelationships. Gastroenterology. 1978 Nov;75(5):901–911. [PubMed] [Google Scholar]
  17. Miller L. J., Owyang C., Malagelada J. R., Gorman C. A., Go V. L. Gastric, pancreatic, and biliary responses to meals in hyperthyroidism. Gut. 1980 Aug;21(8):695–700. doi: 10.1136/gut.21.8.695. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Read N. W., Al-Janabi M. N., Bates T. E., Holgate A. M., Cann P. A., Kinsman R. I., McFarlane A., Brown C. Interpretation of the breath hydrogen profile obtained after ingesting a solid meal containing unabsorbable carbohydrate. Gut. 1985 Aug;26(8):834–842. doi: 10.1136/gut.26.8.834. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Shafer R. B., Prentiss R. A., Bond J. H. Gastrointestinal transit in thyroid disease. Gastroenterology. 1984 May;86(5 Pt 1):852–855. [PubMed] [Google Scholar]
  20. Siurala M., Julkunen H., Lamberg B. A. Gastrointestinal tract in hyperthyroidism before and after treatment. Scand J Gastroenterol. 1966;1(2):79–85. doi: 10.1080/00365521.1966.11800616. [DOI] [PubMed] [Google Scholar]
  21. Siurala M., Varis K., Lamberg B. A. Intestinal absorption and autoimmunity in endocrine disorders. Acta Med Scand. 1968 Jul-Aug;184(1-2):53–64. doi: 10.1111/j.0954-6820.1968.tb02422.x. [DOI] [PubMed] [Google Scholar]
  22. Thomas F. B., Caldwell J. H., Greenberger N. J. Steatorrhea in thyrotoxicosis. Relation to hypermotility and excessive dietary fat. Ann Intern Med. 1973 May;78(5):669–675. doi: 10.7326/0003-4819-78-5-669. [DOI] [PubMed] [Google Scholar]
  23. Wells I., Smith B., Hinton M. Acute ileus in myxoedema. Br Med J. 1977 Jan 22;1(6055):211–212. doi: 10.1136/bmj.1.6055.211-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Wiley Z. D., Lavigne M. E., Liu K. M., MacGregor I. L. The effect of hyperthyroidism on gastric emptying rates and pancreatic exocrine and biliary secretion in man. Am J Dig Dis. 1978 Nov;23(11):1003–1008. doi: 10.1007/BF01263100. [DOI] [PubMed] [Google Scholar]

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