Abnormal Small-Intestinal Endocrine Cells in Patients with Irritable Bowel Syndrome
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.
To investigate a possible abnormality in the small intestinal endocrine cells of IBS patients.
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.
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.
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.
KeywordsComputer image analysis Endocrine cells IBS Small intestine Immunohistochemistry
- 1.Thompson WG. A world view of IBS. In: Camilleri M, Spiller R, eds. Irritable bowel syndrome: diagnosis and treatment. Philadelphia: Saunders; 2002:17–26.Google Scholar
- 3.Thompson WG, Haeton KW. Functional bowel disorders in apparently healthy people. Gastorenterology. 1980;79:283–288.Google Scholar
- 10.O`Keefe EA, Talley NJ, Zinsmeister AR, et al. Bowel disorders impair functional status and quality of life in the elderly: a population-based study. J Biol Sci Med Sci. 1995;50:M184–M189.Google Scholar
- 17.Huerta-Icelo I, Hinojosa C, Santa Maria A, et al. Diferencias en la calidad de vida (CV) entre pacientes con sindrome de Intestino irritable (SII) y la poblacon mexicana evaluadas mediante el SF-36. Rev Mex Gastroenterol. 2001;66(Suppl 2):145–146.Google Scholar
- 18.Schmulson M, Robles G, Kershenobich D, et al. Los pacientes con trastornos funcionales digestivos (TFD) tienen major compromiso de la calidad de vida (CV) evaluadas por el SF-36 comparados con pacientes con hepatitis C y pancreatitis cronica. Rev Mex Gastroenterol. 2000;65(Suppl-Resumenes):50–51.Google Scholar
- 26.El-Salhy M. Gut neuroendocrine system in diabetes gastroenteropathy: possible role in pathophysiology and clinical implications. In: Ford AM, ed. Focus on diabetes mellitus research. New York: Nova Science Publishers; 2006:79–102.Google Scholar
- 37.El-Salhy M, Lillebø E, Reinemo A, Salmelid L. Ghrelin in patients with irritable bowel syndrome. Internat J Mol Med. 2009;23:703–707.Google Scholar