Pathogenesis of Diarrhea in Inflammatory Bowel Disease

  • S. F. Phillips
Part of the Developments in Gastroenterology book series (DIGA, volume 3)


A precise description of the pathogenic mechanisms of diarrhea in inflammatory bowel disease is impossible, for the gaps in our understanding of the physiology of absorption and transit in the small and large intestines are prominent. Given this shaky foundation, all that is certain is that mucosal inflammation must derange these still obscure, normal mechanisms quite variably. Moreover, the clinical spectrum of inflammatory bowel disease is quite wide, anatomically and qualitatively, and it is necessary to distinguish clearly several major categories. The important divisions should perhaps be 1) disease confined to the colon, 2) disease of the small intestine, and 3) diarrhea after proctocolectomy and ileostomy.


Inflammatory Bowel Disease Bile Acid Ulcerative Colitis Ileal Resection Continent Ileostomy 
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  1. 1.
    Smiddy FG, Gregory SD, Smith IB, Goligher JC: Faecal loss of fluid, electrolytes, and nitrogen in colitis before and after ileostomy. Lancet 1: 14–19, 1960.PubMedCrossRefGoogle Scholar
  2. 2.
    Caprilli R, Sopranzi N, Colaneri O, Della Vida ML and de Magistris L: Salt losing diarrhea in ideopathic proctocolitis. Scand J Gastroent 13: 331–335, 1978.PubMedCrossRefGoogle Scholar
  3. 3.
    Hofmann AF (unpublished observations).Google Scholar
  4. 4.
    Schilli R, Breuer RI, Klein F, Dunn K, Gnaedinger A, Bernstein J, Paige M and Kaufman M: A comparison of the composition of fecal fluid in Crohn’s disease and ulcerative colitis. Gut (in press, 1981).Google Scholar
  5. 5.
    Lennard-Jones JE, Cooper GW, Newell AC, Wilson CWE and Jones FA: Observations on idiopathic proctitis. Gut 3: 201–205, 1962.PubMedCrossRefGoogle Scholar
  6. 6.
    Lennard-Jones JE, Langman MJS and Jones FA: Fecal stasis in proctocolitis. Gut 3: 301–304, 1962.PubMedCrossRefGoogle Scholar
  7. 7.
    Denis P, Colin R, Galmiche JP, Geffray Y, Hecketsweiler P, Lefrancois R, Pasquis P: Elastic properties of the rectal wall in normal adults and in patients with ulcerative colitis. Gastroenterology 77: 45–48, 1979.PubMedGoogle Scholar
  8. 8.
    Duthie HL, Watts JM, DeDombal FT and Goligher JC: Serum electrolytes and colonic transfer of water and electrolytes in chronic ulcerative colitis. Gastroenterology 47: 525–530, 1964.PubMedGoogle Scholar
  9. 9.
    Harris J and Shields R: Absorption and secretion of water and electrolytes by the intact human colon in diffuse untreated procto-colitis. Gut 11: 27–33, 1970.PubMedCrossRefGoogle Scholar
  10. 10.
    Head LH, Heaton JW.and Kivel RM: Absorption of water and electrolytes in Crohn’s disease of the colon. Gastroenterology 56: 571–579, 1969.PubMedGoogle Scholar
  11. 11.
    Rask-Madsen J, Hammersgaard EA and Knudsen E: Rectal electrolyte transport and mucosal permeability in ulcerative colitis and Crohn’s disease. J Lab Clin Med 81: 342–353, 1973.PubMedGoogle Scholar
  12. 12.
    Hawker PC, McKay JS and Turnberg LA: Electrolyte transport across colonic mucosa from patients with inflammatory bowel disease. Gastroenterology 79: 508–511, 1980.PubMedGoogle Scholar
  13. 13.
    Archampong EQ, Harris J and Clark CG: The absorption and secretion of water and electrolytes across the healthy and the diseased human colonic mucosa measured in vitro. Gut 13: 880–886, 1972.PubMedCrossRefGoogle Scholar
  14. 14.
    Racusen LC and Binder HJ: Effect of prostaglandin on ion transport across isolated colonic mucosa. Dig Dis Sci 25: 900–904, 1980.PubMedCrossRefGoogle Scholar
  15. 15.
    Hofmann AF: Bile acid malabsorption caused by ileal resection. Arch Int Med 130: 597–605, 1972.CrossRefGoogle Scholar
  16. 16.
    Phillips SF and Gaginella TS: Intestinal secretion as a mechanism in diarrheal disease. IN Progress in Gastroenterology, Vol. III, Ed. G.B. Jerzy Glass, Grune & Stratton, New York, 1977. pp 481–504.Google Scholar
  17. 17.
    Cummings JH, James WPT and Wiggins HS: Role of the colon in ileal resection diarrhea. Lancet 1: 344–347, 1973.PubMedCrossRefGoogle Scholar
  18. 18.
    Mitchell JE, Breuer RI, Zuckerman L, Berlin J, Schilli R, and Dunn JK: The colon influences ileal resection diarrhea. Dig Dis Sci 25: 33–41, 1980.PubMedCrossRefGoogle Scholar
  19. 19.
    McJunkin B, Fromm H, Serva RP and Armin P: Factors in the mechanism of diarrhea in bile acid malabsorption: fecal pH–a key determinant. Gastroenterology 80: 454–464, 1981.Google Scholar
  20. 20.
    Argenzio RA: Short-chain fatty acids and the colon (editorial). Dig Dis Sci 26: 97–99, 1981.PubMedCrossRefGoogle Scholar
  21. 21.
    Hill GL: Ileostomy: Surgery, Physiology and Management. Grune & Stratton, New York, 1976.Google Scholar
  22. 22.
    Kelly DG, Branon ME, Phillips SF and Kelly KA: Diarrhea after continent ileostomy. Gut 21: 711–716, 1980.PubMedCrossRefGoogle Scholar
  23. 23.
    Kelly DG, Phillips SF, Kelly KA, Weinstein WM and Gilchrist MJR: Bacterial overgrowth in the jejunum of patients with ileal pouches (abstract). Gastroenterology 78: 1193, 1980.Google Scholar

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© Martinus Nijhoff Publishers, The Hague 1982

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  • S. F. Phillips

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