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1.
Spiller R. Role of motility in chronic diarrhoea.
Neurogastroenterol Motil. 2006 Dec;18(12):1045-55. Review.
Wolfson Digestive Diseases Centre,
University Hospital, Nottingham, UK.
robin.spiller@nottingham.ac.uk
Patients complaining of 'chronic diarrhoea' usually mean the passage of
loose, urgent stools. Chronic diarrhoea is a feature of malabsorption; it
may also be seen in the 'dumping syndrome' which follows gastric surgery,
small intestinal bacterial overgrowth, bile salt malabsorption and in
malabsorption of simple sugars including most commonly lactose, fructose and
sorbitol. Excessively rapid entry of chyme into the small or large intestine
generates propulsive motor patterns leading to accelerated transit.
Inflammation is associated with decreased normal mixing motor patterns but
increased propulsive motility including high amplitude propagated
contractions (HAPCs). Evidence for abnormal small intestinal motility in the
diarrhoea associated with irritable bowel syndrome (IBS) is conflicting and
any difference appears small. Increased colonic HAPCs with increased
propulsion is seen in IBS with diarrhoea (IBS-D). Stress-induced colonic
motility is increased in IBS-D with hyper-responsiveness to corticotrophin
releasing factor (CRF). Long-lasting increases in mucosal serotonin
availability may contribute to the chronic diarrhoea seen in IBS-D and
coeliac disease. Treatments for abnormal motility in chronic diarrhoea
include those designed to correct specific underlying abnormalities
including octreotide, antibiotics, colestyramine, specific food avoidance
and anti-inflammatory agents. There are also treatments aimed primarily at
altering motility directly including opiates, 5HT3 receptor antagonists and
amitriptyline. |
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15340.
Jardine M,
Kokai GK, Dalzell AM. Enterobius vermicularis and colitis in Children.
J Pediatr Gastroenterol Nutr.
2006 Nov;43(5):610-2.
15341.
Vaishnavi C,
Kaur S. Is Campylobacter involved in antibiotic associated diarrhoea. Indian
J Path Microbiol 2005, 48(4), 526-9.
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