Digestive Diseases and Sciences

, Volume 28, Issue 12, pp 1141–1146

Colonic transport of water and electrolytes in a patient with secretory diarrhea due to collagenous colitis

  • J. Rask-Madsen
  • O. Grove
  • M. G. J. Hansen
  • K. Bukhave
  • Cand Scient
  • R. Henrik-Nielsen
Case Report

DOI: 10.1007/BF01295815

Cite this article as:
Rask-Madsen, J., Grove, O., Hansen, M.G.J. et al. Digest Dis Sci (1983) 28: 1141. doi:10.1007/BF01295815

Summary

Whole colon perfusion studies and measurements of luminal prostaglandin E2 were carried out in a 41-year-old female with collagenous colitis to investigate pathophysiological mechanisms for the diarrhea. Biopsies of the colorectal mucosa had revealed a continuous 25- to 60-μm subepithelial collagenous layer, but normal junctional complexes and capillaries. When the patient fasted, the diarrhea persisted and fecal electrolytes, as estimated from the concentration of sodium, potassium, and their anions, accounted for all the osmolality (284 mosm/kg) of stool water, the pH of which was above 8.0. The lumen-negative electrical potential difference in the rectum was −64 mV vs −45±2 mV (mean±sem) in healthy controls. Profuse secretion of fluid and electrolytes occurred during colonic perfusion with saline. Transport of sodium appeared to be passive with flux ratios equal to those predicted for passive sodium movements, while chloride transport against a steep electrical gradient indicated active secretion. Perfusion with an “ileal output”-like solution decreased fluid and electrolyte secretion, suggesting that bicarbonate, in addition to chloride, may be a major determinant of secretion rates. Since immunoreactive prostaglandin E2 levels followingin vivo equilibrium dialysis of feces ranged from 555 to 650 pg/ml vs 55 to 235 pg/ml (99% confidence limits) in healthy controls, it is speculated that prostaglandins synthesized locally in response to mucosal hypoxia might be the mediators of anion secretion.

Copyright information

© Plenum Publishing Corporation 1983

Authors and Affiliations

  • J. Rask-Madsen
    • 1
    • 2
    • 3
  • O. Grove
    • 1
    • 2
    • 3
  • M. G. J. Hansen
    • 1
    • 2
    • 3
  • K. Bukhave
    • 1
    • 2
    • 3
  • Cand Scient
    • 1
    • 2
    • 3
  • R. Henrik-Nielsen
    • 1
    • 2
    • 3
  1. 1.Department of Medical GastroenterologyOdense University HospitalOdense CDenmark
  2. 2.Institute of PathologyOdense University HospitalCopenhagenDenmark
  3. 3.Department of Medicine CHerlev HospitalCopenhagenDenmark