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Gut hormones and gastrointestinal motility in children with cystic fibrosis

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Abstract

Intestinal dysmotility may be an important factor contributing to various gastrointestinal complications associated with cystic fibrosis. Motilin, enteroglucagon, neurotensin, and peptide YY may each play a role as endocrine hormones influencing gastrointestinal motor activity. Fasting children with cystic fibrosis (N=8) and controls (N=18) received a liquid nutrient test meal (fat 4 g/100 ml, protein 4 g/100 ml, carbohydrate 20 g/100 ml, 125 kcal/100 ml; 200 ml/m2) containing lactulose (5 g/100 ml), and the plasma concentrations of these peptides were studied. Mouth-to-cecum transit time was simultaneously studied using the breath H2 technique. Fasting levels of peptide YY and the postprandial response of all four peptides were significantly increased in those with cystic fibrosis. In repeat studies on those with cystic fibrosis after a period of altered pancreatic enzyme supplementation, no significant changes in peptide concentrations were observed. A rise in breath H2 permitting estimation of mouth-to-cecum transit time was noted in 17 control subjects (70–220 min, median 140). In contrast, a rise occurred in only two with cystic fibrosis after low-dose enzyme (70 and 180 min), and four after high-dose enzyme replacement (120–230 min, median 155). Altered gut hormone secretion may play a role in the pathophysiology of intestinal dysmotility in patients with cystic fibrosis.

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Authors and Affiliations

  1. Department of Child Health, The Medical School, University of Newcastle upon Tyne, Newcastle, UK

    M. S. Murphy BSc, MD, MRCP, DCH, A. L. Brunetto MD, MSc, PhD, A. D. J. Pearson MD, MRCP, DCH, R. Nelson MBCHb, FRCP, DCH, E. J. Eastham MB, BS, FRCP & A. Aynsley Green MA, DPhil, MB, BS, FRCP

  2. Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK

    M. A. Ghatei MSc & S. R. Bloom MA, DSc, MD, FRCP

Authors
  1. M. S. Murphy BSc, MD, MRCP, DCH
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  2. A. L. Brunetto MD, MSc, PhD
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  3. A. D. J. Pearson MD, MRCP, DCH
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  4. M. A. Ghatei MSc
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  5. R. Nelson MBCHb, FRCP, DCH
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  6. E. J. Eastham MB, BS, FRCP
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  7. S. R. Bloom MA, DSc, MD, FRCP
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  8. A. Aynsley Green MA, DPhil, MB, BS, FRCP
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Murphy, M.S., Brunetto, A.L., Pearson, A.D.J. et al. Gut hormones and gastrointestinal motility in children with cystic fibrosis. Digest Dis Sci 37, 187–192 (1992). https://doi.org/10.1007/BF01308170

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  • DOI: https://doi.org/10.1007/BF01308170

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