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Abnormal Small-Intestinal Endocrine Cells in Patients with Irritable Bowel Syndrome

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Abstract

Background

General disturbances in gastrointestinal motility have been reported in patients with irritable bowel syndrome (IBS). The gastrointestinal tract hormones play an important role in regulating gastrointestinal motility.

Aims

To investigate a possible abnormality in the small intestinal endocrine cells of IBS patients.

Methods

Included in the study were 41 patients with irritable bowel syndrome according to Rome Criteria III and 42 healthy controls. Duodenal biopsies were obtained from both patients and controls during gastroscopy. The biopsies were immunostained by avidin–biotin-complex method for secretin, CCK, GIP, somatostatin, and serotonin cells. The cell densities were quantified by computerized image analysis.

Results

The density of secretin- and CCK-immunoreactive cells in patients with IBS was significantly reduced. The reduction in secretin and CCK cells occurred only in IBS-diarrhea patients, but not in IBS-constipation subtype. Both GIP and somatostatin cell densities were reduced in the duodenum of IBS patients. There was no statistical difference between the subtypes of IBS patients, regarding secretin, CCK, GIP, or somatostatin cell densities. Serotonin cell density was not affected in patients with IBS.

Conclusions

The low densities of secretin and CCK cells in IBS-diarrhea patients may cause a functional pancreatic insufficiency as well as inadequate gall emptying, as these hormones stimulate pancreatic bicarbonate and enzyme secretion and CCK stimulates as well gall bladder contraction. Low densities of secretin, GIP, and somatostatin cells in IBS patients might result in a high secretion of gastric acid, as secretin, GIP, and somatostatin inhibit gastric acid secretion.

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Acknowledgments

The authors wish to thank the nurses at the endoscopy unit, Stord hospital: Elli Lillebø, Astrid Reinemo, and Lillian Salmelid for their unfailing enthusiasm and for assisting under gastroscopy and biopsy collection. We would like to express our gratitude to Professor Hans Olav Fadnes, Head of the Department of Medicine, Stord Helse-Fonna Hospital, for his support and for reading the manuscript. This study was supported by a grant from Helse-Fonna.

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Authors and Affiliations

  1. Section for Gastroenterology, Department of Medicine, Stord Helse-Fonna Hospital, Box 4000, 54 09, Stord, Norway

    Magdy El-Salhy

  2. Section for Gastroenterology, Institute of Medicine, University of Bergen, Bergen, Norway

    Magdy El-Salhy, K. Vaali, V. Dizdar & T. Hausken

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  1. Magdy El-Salhy
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  2. K. Vaali
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Correspondence to Magdy El-Salhy.

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El-Salhy, M., Vaali, K., Dizdar, V. et al. Abnormal Small-Intestinal Endocrine Cells in Patients with Irritable Bowel Syndrome. Dig Dis Sci 55, 3508–3513 (2010). https://doi.org/10.1007/s10620-010-1169-6

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  • DOI: https://doi.org/10.1007/s10620-010-1169-6

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