Perri F, Pastore M, Zicolella A, Annese V, Quitadamo M, Andriulli A
Division of Gastroenterology, Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy.
Acta Paediatr. 2000 Aug;89(8):921-5. doi: 10.1080/080352500750043341.
Several gastrointestinal motor abnormalities have been detected in patients with celiac disease, but it is unclear whether they are able to influence the gastric emptying rate. The aim of this work was to evaluate the gastric emptying rate of solids in children with celiac disease before and after a gluten-free diet. Nine children with celiac disease and nine healthy controls (age range 4-16 y) underwent a 13C-octanoic acid breath test to measure gastric emptying. Half emptying time (t1/2) and lag phase (t(lag)) were calculated. After 6 mo of a gluten-free diet, all celiac children underwent a repeat 13C-octanoic acid breath test. The gastric motility parameters, t1/2 and t(lag), were significantly longer in patients than in controls. No significant correlation between abnormal gastric emptying and specific symptom patterns or severity of histological damage was found. On a gluten-free diet, the gastric emptying rate normalized in all celiac patients. This finding supports the hypothesis that gluten-driven mucosal inflammation might determine motor abnormalities by affecting smooth muscle contractility or impairing the release of neurotransmitters. Alternatively, nutrient malabsorption might determine significant changes in intraluminal milieu, which, in turn, may affect intestinal motor functions.
patients affected by celiac disease have a markedly delayed gastric emptying of solids, which returns to normal after gluten withdrawal.
乳糜泻患者已检测出多种胃肠运动异常，但尚不清楚它们是否会影响胃排空率。这项研究的目的是评估乳糜泻患儿在无麸质饮食前后固体食物的胃排空率。9名乳糜泻患儿和9名健康对照者（年龄范围4 - 16岁）接受了13C - 辛酸呼气试验以测量胃排空。计算半排空时间（t1/2）和延迟期（t(lag)）。在无麸质饮食6个月后，所有乳糜泻患儿再次接受13C - 辛酸呼气试验。患者的胃动力参数t1/2和t(lag)明显长于对照组。未发现胃排空异常与特定症状模式或组织学损伤严重程度之间存在显著相关性。在无麸质饮食时，所有乳糜泻患者的胃排空率恢复正常。这一发现支持了以下假设：麸质驱动的黏膜炎症可能通过影响平滑肌收缩力或损害神经递质释放来决定运动异常。或者，营养吸收不良可能导致肠腔内环境发生显著变化，进而可能影响肠道运动功能。
乳糜泻患者固体食物的胃排空明显延迟，在戒除麸质后恢复正常。
