Abstract
In order to determine whether failure of the colon to salvage carbohydrate could contribute to the diarrhoea of ulcerative colitis we investigated the effect of ingesting a drink containing 20 g lactulose on stool output and breath hydrogen production in 39 colitic patients subdivided according to their disease extent and activity and in 14 normal volunteers. Each subject took a standard diet for four days and stool output was monitored throughout this period. Administration of lactulose on day three significantly increased stool weight and frequency in patients with both active and quiescent total colitis (p less than 0.01), but not in patients with distal colitis or in the volunteers. The basal and peak breath hydrogen responses to ingested lactulose were similar to normal controls in all patient groups but the hydrogen concentration tended to be higher in colitics. The mouth to caecum transit of the lactulose meal was slower in all groups of colitics (p less than 0.02) when compared with controls. These results suggest that impaired colonic salvage of carbohydrate could contribute to the diarrhoea in patients with total colitis who are ingesting a diet rich in unabsorbed carbohydrate, or who are hypolactasic.
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Selected References
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- Archampong E. Q., Harris J., Clark C. G. The absorption and secretion of water and electrolytes across the healthy and the diseased human colonic mucosa measured in vitro. Gut. 1972 Nov;13(11):880–886. doi: 10.1136/gut.13.11.880. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Binder J. H., Gryboski J. D., Thayer W. R., Jr, Spiro H. M. Intolerance to milk in ulcerative colitis. A preliminary report. Am J Dig Dis. 1966 Nov;11(11):858–864. doi: 10.1007/BF02233942. [DOI] [PubMed] [Google Scholar]
- Bond J. H., Currier B. E., Buchwald H., Levitt M. D. Colonic conservation of malabsorbed carbohydrate. Gastroenterology. 1980 Mar;78(3):444–447. [PubMed] [Google Scholar]
- CHAUDHARY N. A., TRUELOVE S. C. Human colonic motility: a comparative study of normal subjects, patients with ulcerative colitis, and patients with the irritable colon syndrome. I. Resting patterns of motility. Gastroenterology. 1961 Jan;40:1–17. [PubMed] [Google Scholar]
- Cady A. B., Rhodes J. B., Littman A., Crane R. K. Significance of lactase deficit in ulcerative colitis. J Lab Clin Med. 1967 Aug;70(2):279–286. [PubMed] [Google Scholar]
- Chauve A., Devroede G., Bastin E. Intraluminal pressures during perfusion of the human colon in situ. Gastroenterology. 1976 Mar;70(3):336–340. [PubMed] [Google Scholar]
- Cummings J. H. Colonic absorption: the importance of short chain fatty acids in man. Scand J Gastroenterol Suppl. 1984;93:89–99. [PubMed] [Google Scholar]
- DAWSON A. M., HOLDSWORTH C. D., WEBB J. ABSORPTION OF SHORT CHAIN FATTY ACIDS IN MAN. Proc Soc Exp Biol Med. 1964 Oct;117:97–100. doi: 10.3181/00379727-117-29505. [DOI] [PubMed] [Google Scholar]
- Farthing M. J., Lennard-jones J. E. Sensibility of the rectum to distension and the anorectal distension reflex in ulcerative colitis. Gut. 1978 Jan;19(1):64–69. doi: 10.1136/gut.19.1.64. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kretchmer N. The geography and biology of lactose digestion and malabsorption. Postgrad Med J. 1977;53 (Suppl 2):65–72. [PubMed] [Google Scholar]
- Manousos O. N., Salem S. N. Abnormal motility of the small intestine in ulcerative colitis. Gastroenterologia. 1965;104(4):249–257. doi: 10.1159/000202102. [DOI] [PubMed] [Google Scholar]
- Montgomery R. D., Frazer A. C., Hood C., Goodhart J. M., Holland M. R., Schneider R. Studies of intestinal fermentation in ulcerative colitis. Gut. 1968 Oct;9(5):521–526. doi: 10.1136/gut.9.5.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newcomer A. D., McGill D. B. Incidence of lactase deficiency in ulcerative colitis. Gastroenterology. 1967 Dec;53(6):890–893. [PubMed] [Google Scholar]
- Palma R., Vidon N., Bernier J. J. Maximal capacity for fluid absorption in human bowel. Dig Dis Sci. 1981 Oct;26(10):929–934. doi: 10.1007/BF01309499. [DOI] [PubMed] [Google Scholar]
- Pomare E. W., Branch W. J., Cummings J. H. Carbohydrate fermentation in the human colon and its relation to acetate concentrations in venous blood. J Clin Invest. 1985 May;75(5):1448–1454. doi: 10.1172/JCI111847. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Read N. W. Diarrhoea: the failure of colonic salvage. Lancet. 1982 Aug 28;2(8296):481–483. doi: 10.1016/s0140-6736(82)90504-9. [DOI] [PubMed] [Google Scholar]
- Roediger W. E., Heyworth M., Willoughby P., Piris J., Moore A., Truelove S. C. Luminal ions and short chain fatty acids as markers of functional activity of the mucosa in ulcerative colitis. J Clin Pathol. 1982 Mar;35(3):323–326. doi: 10.1136/jcp.35.3.323. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ruppin H., Bar-Meir S., Soergel K. H., Wood C. M., Schmitt M. G., Jr Absorption of short-chain fatty acids by the colon. Gastroenterology. 1980 Jun;78(6):1500–1507. [PubMed] [Google Scholar]
- SPRIGGS E. A., CODE C. F., BARGEN J. A., CURTISS R. K., HIGHTOWER N. C., Jr Motility of the pelvic colon and rectum of normal persons and patients with ulcerative colitis. Gastroenterology. 1951 Nov;19(3):480–491. [PubMed] [Google Scholar]
- Saunders D. R., Wiggins H. S. Conservation of mannitol, lactulose, and raffinose by the human colon. Am J Physiol. 1981 Nov;241(5):G397–G402. doi: 10.1152/ajpgi.1981.241.5.G397. [DOI] [PubMed] [Google Scholar]
- TRUELOVE S. C. Ulcerative colitis provoked by milk. Br Med J. 1961 Jan 21;1(5220):154–160. doi: 10.1136/bmj.1.5220.154. [DOI] [PMC free article] [PubMed] [Google Scholar]
- TRUELOVE S. C., WITTS L. J. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955 Oct 29;2(4947):1041–1048. doi: 10.1136/bmj.2.4947.1041. [DOI] [PMC free article] [PubMed] [Google Scholar]
- WRIGHT R., TRUELOVE S. C. CIRCULATING ANTIBODIES TO DIETARY PROTEINS IN ULCERATIVE COLITIS. Br Med J. 1965 Jul 17;2(5454):142–144. doi: 10.1136/bmj.2.5454.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
