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Elevated motility-related transmucosal potential difference in the upper small intestine in the irritable bowel syndrome.

Journal article
Authors Marie H Larsson
Magnus Simrén
E A Thomas
J C Bornstein
E Lindström
Henrik Sjövall
Published in Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
Volume 19
Issue 10
Pages 812-20
ISSN 1350-1925
Publication year 2007
Published at Institute of Neuroscience and Physiology, Department of Physiology
Institute of Medicine, Department of Internal Medicine
Pages 812-20
Language en
Keywords Adult, Duodenum, physiopathology, Fasting, Female, Gastrointestinal Motility, physiology, Humans, Intestinal Mucosa, secretion, Irritable Bowel Syndrome, physiopathology, Jejunum, physiopathology, Male, Manometry, Middle Aged, Myoelectric Complex, Migrating, physiology
Subject categories Gastroenterology and Hepatology


The pathophysiology of irritable bowel syndrome (IBS) is complex and incompletely known. Very little has been studied regarding the role of submucous neuronal activity. We therefore measured small intestinal transmural potential difference (PD, reflecting mainly electrogenic chloride secretion), and its linkage with fasting motor activity [migrating motor complex (MMC)] in controls (n = 16) and patients with IBS [n = 23, 14 diarrhoea predominant (d-IBS) and nine constipation predominant (c-IBS)]. Transmural-PD and its relation to MMC phase III was measured by modified multilumen manometry for 3 h in the fasting state using one jejunal and one duodenal infusion line as flowing electrodes. The amplitude and duration of motor phase III was similar in controls and IBS patients, but the propagation speed of phase III was higher in IBS patients. In IBS patients, maximal PD during MMC phase III was significantly elevated in both the duodenum and jejunum (P < 0.05) and the PD decline after phase III was significantly prolonged in the jejunum (P < 0.01). The PD elevation was seen in both duodenum and jejunum in d-IBS patients, but only in the jejunum in the c-IBS patients. On the basis of previous modelling studies, we propose that the enhanced secretion may reflect disturbed enteric network behaviour in some patients with IBS.

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