Skip to main content
SpringerLink
Log in

The effect of cathartic agents on transmucosal electrical potential difference in the human rectum

Einfluß laxierender Substanzen auf die transmucöse elektrische Potentialdifferenz im menschlichen Rektum

  • Originalien
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Zusammenfassung

Eine elektrische transmurale Potentialdifferenz (PD) von ca. 40 mV wird im Colon durch einen aktiven Ionentransport erzeugt. Laxierend wirkende Substanzen hemmen die Elektrolyt- und Wassernettoresorption oder verursachen eine Nettosekretion, was auch einen Einfluß auf die PD erwarten läßt.

Bei 83 Normalpersonen wurde eine isotone Elektrolytlösung (Kontrollgruppe) und folgende laxierende Substanzen getestet: Laxantien (Bisacodyl, Rhein), Gallensäuren (Chol- und Desoxycholsäuren), Fettsäuren (Öl- und Rizinolsäure) und Herzglykoside (Meproscillarin, Digitoxin, Digoxin). Bisacodyl, Desoxycholsäure in hoher Konzentration, Meproscillarin und Digitoxin verringerten die PD signifikant, die anderen Substanzen hatten keinen wesentlichen Effekt. Laxierend wirkende Substanzen wirken auf verschiedene Transportmechanismen. Dies zusammen mit den unterschiedlichen Resorptionscharakeristika im proximalen und distalen Colon könnten die Unterschiede der Wirkung auf die PD erklären. Die rektale PD-Messung bietet eine einfache und brauchbare Methode, die Wirkungen laxierender Substanzen zu dokumentieren, welche sonst schwer zu erfassen sind und eignet sich für eine klinische Anwendung.

Summary

Active ion transport in the colon is generating a transmucosal electrical potential difference (PD) of about 40 mV. Cathartic agents inhibit electrolyte and water net-absorption or cause net-secretion which should be reflected in a change of PD.

In 83 normal subjects the effect of an isotonic eletrolyte solution (control) and different cathartic agents on rectal PD was tested: Laxatives (bisacodyl, rhein), bile acids (cholic and deoxycholic acid), fatty acids (oleic and ricinoleic acid) and cardiac glycosides (meproscillarin, digitoxin, digoxin). Bisacodyl, deoxycholic acid in high concentration, meproscillarin and digitoxin significantly decreased PD, while the other substances did not.

Cathartics act on different transport mechanisms which together with different absorption characteristics of the proximal and distal colon may explain the difference in effecting the PD. Rectal PD measurement provides an easy and convenient tool to document effects of cathartic agents on electrolyte transport, otherwise difficult to obtain, and is applicable for clinical use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Ammon, H.V., Phillips, S.F.: Inhibition of colonic water and electrolyte absorption by fatty acids in man. Gastroenterology65, 744–749 (1973)

    PubMed  Google Scholar 

  • Archampong, E.Q., Edmonds, D.J.: Effect of luminal ions on the transepithelial electric potential difference in human rectum. Gut13, 559–565 (1972)

    PubMed  Google Scholar 

  • Beevers, D.G.: Mineralocorticoids and rectal potential difference. Lancet1973II, 682–683

    Google Scholar 

  • Beevers, D.G., Morton, J.J., Tree, M., Joung, J.: Rectal potential difference in the diagnosis of aldosterone excess. Gut16, 36–41 (1975)

    PubMed  Google Scholar 

  • Binder, H.J.: Bile salt stimulation of colonic cyclic-AMP: mechanism of bile salt induced electrolyte secretion? In: Advances in bile research. J. Matern, J. Hackenschmidt, P. Back, W. Gerock (eds.), pp. 425–428. Stuttgart-New York: Schattauer 1975

    Google Scholar 

  • Bright-Asare, P., Binder, H.J.: Stimulation of colonic secretion of water and electrolytes by hydroxy fatty acids. Gastroenterology64, 81–88 (1973)

    PubMed  Google Scholar 

  • Chadwick, V.S., Phillips, S.F., Hofmann, A.F.: Measurement of intestinal permeability using low molecular weight polyethylene glycols (PEG 400). II. Application to normal and abnormal permeability states in man and animals. Gastroenterology73, 247–251 (1977)

    PubMed  Google Scholar 

  • Chignell, D.F.: The effect of phenolphthalein and other purgative drugs on rat intestinal (Na+, K+) adenosine triphosphatase. Biochem. Pharmacol.17, 1207–1212 (1968)

    PubMed  Google Scholar 

  • Conley, D.R., Coyne, M.J., Bonarris, G.G., Chung, A., Schoenfield, L.J.: Bile acid stimulation of colonic adenylate cyclase and secretion in the rabbit. Am. J. Dig. Bis.21, 453–458 (1976)

    Google Scholar 

  • Cooperstein, J.L., Brockman, S.K.: The electrical potential difference generated by the large intestine: its relation to electrolyte and water transfer. J. Clin. Invest.38, 435–442 (1959)

    PubMed  Google Scholar 

  • Corazza, G.R., Ciccarelli, R., Caciagli, F., Gasparrini, G.: Cyclic AMP and cyclic GMP levels in human colonic mucosa before and during chenodeoxycholic acid therapy. Gut20, 489–492 (1979)

    PubMed  Google Scholar 

  • Csaky, T.Z., Hara, Y.: Inhibition of active intestinal transport by digitalis. Am. J. Physical.209, 467–472 (1965)

    Google Scholar 

  • Dalmark, M.: The transmucosal electrical potential difference of rectum in the unaesthetized man. Scand. J. Gastroenterol.5, 277–282 (1970a)

    PubMed  Google Scholar 

  • Dalmark, M.: The transmucosal electrical potential difference across the human rectum in vivo following perfusion of different electrolyte solutions. Scand. J. Gastroenterol.5, 421–426 (1970b)

    PubMed  Google Scholar 

  • Devroede, G.J., Phillips, S.F.: Failure of the human rectum to absorb electrolytes and water. Gut11, 438–442 (1970)

    PubMed  Google Scholar 

  • Edmonds, C.J.: Electrical potentials of the sigmoid colon and rectum in irritable bowel syndrome and ulcerative colitis. Gut11, 867–874 (1970)

    PubMed  Google Scholar 

  • Edmonds, C.J.: Absorption of sodium and water by human rectum measured by a dialysis method. Gut12, 356–362 (1971)

    PubMed  Google Scholar 

  • Edmonds, C.J., Godfrey, R.C.: Measurement of electrical potential of the human rectum and pelvic colon in normal and aldosterone-treated patients. Gut11, 330–337 (1970)

    PubMed  Google Scholar 

  • Edmonds, C.J., Pilcher, D.: Electrical potential difference and sodium and potassium fluxes across rectal mucosa in ulcerative colitis. Gut14, 784–789 (1973)

    PubMed  Google Scholar 

  • Edmonds, C.J., Richards, P.: Measurement of rectal electrical potential difference as an instant screening-test for hyperaldosteronism. Lancet1970II, 624–627

    Google Scholar 

  • Eichhorn, T.: Einfluß exogener und endogener Faktoren auf die transepitheliale elektrische Potentialdifferenz am Colon der Ratte in vivo. Thesis Johannes Gutenberg Universität, Mainz 1980

    Google Scholar 

  • Ewe, K.: Effect of laxatives on intestinal water and electrolyte transport. Eur. J. Clin. Invest.2, 288 (1972) (Abstract)

    Google Scholar 

  • Ewe, K.: The physiological basis of laxative action. Pharmacology,20, [Suppl. 1] 2–20 (1980a)

    PubMed  Google Scholar 

  • Ewe K.: Effect of rhein on transport of electrolyte, water, and carbohydrates in the human jejunum and colon. Pharmacology,20 [Suppl. 1] 27–35 (1980b)

    Google Scholar 

  • Ewe, K., Hölker, B.: Einfluß eines diphenolischen Laxans (Bisacodyl) auf den Wasser- und Elektrolyttransport im menschlichen Colon. Klin. Wochenschr.52, 827–833 (1974)

    PubMed  Google Scholar 

  • Ewe, K., Wanitschke, R., Schulze, K.H., Weber, H.: Die sekretagoge Wirkung des Glycosids Methyl-Proscillaridin im menschlichen Dünn- und Dickdarm Verh. Dtsch. Ges. Verdauungs-u. Stoffwechselkrankheiten Hamburg 1978

  • Fordtran, G.S., Rector, F.L., Ewton, M.F., Soter, N., Kinney, G.: Permeability characteristics of the human small intestine. J. Clin. Invest.44, 1935–1944 (1965)

    PubMed  Google Scholar 

  • Forth, W., Furukawa, E., Rummel, W.: Intestinale Resorption von Herzglycosiden in vitro und in vivo. Naunyn Schmiedebergs Arch. Pharmacol.262, 53–72 (1969)

    Google Scholar 

  • Forth, W., Rummel, W., Glasner, H.: Zur resorptionshemmenden Wirkung von Gallensäuren. Naunyn Schmiedebergs Arch. Pharmacol.254, 364–380 (1966)

    Google Scholar 

  • Frömter, E., Diamond, G.: Route of passive ion permeation in epithelia. Nature (New Biol.)235, 9–13 (1972)

    Google Scholar 

  • Gaginella, T.S., Phillips, S.F., Dozois, R.R., Go, V.L.W.: Stimulation of adenylate cyclase in homogenates of isolated intestinal epithelial cells in the hamsters. Effect of gastrointestinal hormones, prostaglandines, and deoxycholic and ricinoleic acid. Gastroenterology74, 11–15 (1978)

    PubMed  Google Scholar 

  • Geall, M.G., Code, C.F., McIlrath, D.C., Summerskill, W.H.J.: Measurement of gastrointestinal transmural electrical potential difference in man. Gut11, 34–37 (1970)

    PubMed  Google Scholar 

  • Goerg, K.J.: Diarrhoe — ein Resultat zellulärer und parazellulärer Sekretion. Eine vergleichende Studie des Effekts von Choleratoxin und Desoxycholat auf Flüssigkeits- und Elektrolytfluxe, auf die parazelluläre Permeabilität und auf den Elektrolytgehalt der Colonmukosa der Ratten in vivo. (In Vorbereitung)

  • Gracey, M., Papadimitriou, J., Burke, V., Thomas, G., Bower, G.: Effects on small intestinal function and structure induced by feeding a deconjugated bile salt. Gut14, 519–528 (1973)

    PubMed  Google Scholar 

  • Krämer, K.D., Hochrein, A.: Enterale Verfügbarkeit und therapeutische Wirksamkeit von Proscillaridin-4′-Methyläther. Arzneimittelforsch.26, 579–583 (1976)

    PubMed  Google Scholar 

  • Lemmens, L., Borja, E.: The influence of dihydroxyanthracene derivatives on water and electrolyte movements in the rat colon. J. Pharm. Pharmacol.28, 498–501 (1976)

    PubMed  Google Scholar 

  • Leopold, G., Furukawa, E., Forth, W., Rummel, W.: Binding of cardiac glycosides to isolates of jejunal brush borders from rat and guinea pig and their influence on membrane phosphatase systems. Biochem. Pharmacol.20, 1109–1117 (1971)

    PubMed  Google Scholar 

  • Loeschke, K.: Na-K-ATPase and cAMP in diarrhea due to diphenolic catharics. Gastroenterol. Clin Biol.3, 179 (1979) (abstract)

    Google Scholar 

  • Levitan, R., Fordtran, J.S., Burrows, B.A., Ingelfinger, F.J.: Water and salt absorption in the human colon. J. Clin. Invest.41, 1754–1759 (1962)

    PubMed  Google Scholar 

  • Mekhjian, H.S., Phillips, S.F., Hofmann, A.F.: Colonic secretion of water and electrolytes induced by bile acids: Perfusion studies in man. J. Clin. Invest.50, 1569–1577 (1971)

    PubMed  Google Scholar 

  • Nell, G.W., Forth, T., Freiberger, T., Rummel, W., Wanitschke, R.: Characterization of permeability changes by test molecules in rat colonic mucosa under the influence of sodium deoxycholate. In: Intestinal permeation, 4th Workshop conference, Hoechst, 1975, M. Kramer, F. Lauterbach (eds.), pp. 419–424. Amsterdam, Oxford: Excerpta Medica 1970

    Google Scholar 

  • Nell, G., Forth, W., Rummel, W., Wanitschke, R.: Pathway of sodium moving from blood to intestinal lumen under the influence of oxyphenisation and deoxycholate. Naunyn Schmiedebergs Arch. Pharmacol.293, 31–37 (1976)

    Google Scholar 

  • Oddsson, E., Rask-Madsen, J., Krag, E.: Effect of glycochenodeoxycholic acid on unidirectional transepithelial fluxes of electrolytes in the perfused human ileum. Scand. J. Gastroenterol.12, 199–204 (1977)

    PubMed  Google Scholar 

  • Rachmilewitz, D., Karmeli, F.: Effect of bisacodyl (Bis) and dioctyl sodium sulfosuccinate (DSS) on rat intestinal prostaglandin E2 (PGE2), Na-K-ATPase and adenylcyclase activities. Gastroenterology75, 1221 (1979) (abstract)

    Google Scholar 

  • Rask-Madsen, J.: Simultanous measurement of electrical polarization and electrolyte transport by the entire normal and inflamed human colon during in vivo perfusion. Scand. J. Gasteroenterol.8, 327–334 (1973)

    Google Scholar 

  • Rask-Madsen, J., Brix-Jensen, P.: Electrolyte transport capacity and electrical potentials of the normal and the inflamed human rectum in vivo. Scand. J. Gastroenterol.8, 169–175 (1973)

    PubMed  Google Scholar 

  • Rask-Madsen, J., Bruusgaard, A., Munck, O., Nielsen, M.D., Warning, H.: The significance of bile acids and aldosterone for the electrical hyperpolarization of human rectum in obese patients treated with intestinal bypass operation. Scand. J. Gastroenterol.9, 417–426 (1974)

    PubMed  Google Scholar 

  • Rask-Madsen, J., Dalmark, M.: Decreased transmural potential difference across the human rectum in ulcerative colitis. Scand. J. Gastroenterol.8, 321–326 (1973)

    PubMed  Google Scholar 

  • Rask-Madsen, J., Hammersgaard, E.A., Knudsen, E.: Rectal electrolyte transport and mucosal permeability in ulcerative colit and Crohn's disease. J. Lab. Clin. Med.81, 342–352 (1973)

    PubMed  Google Scholar 

  • Rask-Madsen, J., Hjelt, K.: Effect of amiloride on electrical activities and electrolyte transport in human colon. Scand. J. Gastroenterol.12, 1–6 (1977)

    PubMed  Google Scholar 

  • Read, N.W., Fordtran, J.S.: The role of intraluminal junction potentials on the generation of the gastric potential difference in man. Gastroenterology76, 932–938 (1979)

    PubMed  Google Scholar 

  • Ruddell, W.S.J., Blendis, L.M., Lovell, D.: Rectal potential difference and histology in Crohn's disease. Gut18, 284–289 (1977)

    PubMed  Google Scholar 

  • Simon, B., Czygan, P., Stiehl, A., Kather, H.: Human colonic adenylate cyclase: effects of bile acids. Eur. J. Clin. Invest.8, 321–323 (1978)

    PubMed  Google Scholar 

  • Skrabal, F., Anböck, J., Dewards, C.R.W., Braunsteiner, H.: Substraction potential difference: in vivo assay for mineralocorticoid activity. Lancet1978I, 298–302

    Google Scholar 

  • Skrabal, F., Mauser, R.: Rektale elektrische Potentialdifferenz und Plasmaaldosteron bei Hyperaldosteronismus und essentieller Hypertonie bei erniedrigtem und erhöhtem Renin. Wien. Klin. Wochenschr.88, 777–781 (1976)

    PubMed  Google Scholar 

  • Specht, W.: Morphology of the intestinal wall. Its mucous membranes under normal and experimental conditions. In: Intestinal permeation, 4th Workshop conference, Hoechst, 1975, M. Kramer, F. Lauterbach (eds.), pp. 4–40. Amsterdam, Oxford: Excerpta Medica 1977

    Google Scholar 

  • Staud, R., Rietbrock, N., Faßbender, H.P.: Excretion of methylproscillaridin in patients with a biliary fistula. Eur. J. Clin. Pharmacol.9, 99–103 (1975)

    PubMed  Google Scholar 

  • Tomkins, A.M., Edmonds, C.J.: Electrical potential difference, sodium absorption and potassium secretion by the human rectum during carbenoxolone therapy. Gut16, 277–284 (1975)

    PubMed  Google Scholar 

  • Wanitschke, R.: Influence of rhein on the electrolyte and water transport in the isolated rat colon. Pharmacology,20, [Suppl. 1] 21–26 (1980)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. I. Medizinische Klinik und Poliklinik der Johannes Gutenberg-Universität Mainz, Germany

    K. Ewe & R. Wanitschke

Authors
  1. K. Ewe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Wanitschke
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

To Prof. Dr. H.P. Wolff on the occasion of his 65th birthday

This work was supported by a grant of the Deutsche Forschungsgemeinschaft Ew4/11

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ewe, K., Wanitschke, R. The effect of cathartic agents on transmucosal electrical potential difference in the human rectum. Klin Wochenschr 58, 299–306 (1980). https://doi.org/10.1007/BF01476572

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01476572

Schlüsselwörter

Key words

Search

Navigation