Wegener M, Schaffstein J, Dilger U, Coenen C, Wedmann B, Schmidt G
Department of Medicine, St. Josef-Hospital, Ruhr-University Bochum, Germany.
Dig Dis Sci. 1991 Jul;36(7):917-23. doi: 10.1007/BF01297141.
Gastric emptying, mouth-to-cecum transit, and whole-gut transit of a solid-liquid meal were measured in 46 chronic alcoholics and in 30 control subjects by using scintigraphic techniques, hydrogen breath test, and stool markers. In the alcoholics various parameters such as ethanol consumption, gastrointestinal symptoms, and alcoholic neuropathy were determined and related to gastrointestinal transit times. Although there was no significant overall difference of gastric emptying, abnormally delayed gastric emptying was detected in 23.9% of the alcoholics but no control subject (P less than 0.005). Mouth-to-cecum transit was significantly prolonged in the alcoholics (P less than 0.001) with 14 alcoholics (37.8%) disclosing delayed mouth-to-cecum transit. No significant differences between both groups were detected concerning whole gut transit. In the alcoholics there was a significant correlation of dyspeptic symptoms with delayed gastric emptying (P less than 0.006), and alcoholics with diarrhea had an accelerated mouth-to-cecum transit as compared to those without diarrhea (P less than 0.05). Neither the presence of autonomic or peripheral neuropathy nor the presence of liver cirrhosis or ascites was significantly related to gastrointestinal transit times. However, the daily ethanol ingestion significantly correlated with gastric emptying (P less than 0.005). It is concluded, therefore, that in chronic alcoholics the small intestine and the stomach are most likely to be affected by gastrointestinal transit disorders and that these transit abnormalities are potentially related to toxic damage of gastrointestinal smooth muscle.
采用闪烁扫描技术、氢呼气试验和粪便标记物,对46名慢性酒精中毒者和30名对照者进行了固体-液体餐的胃排空、口至盲肠转运和全肠道转运的测定。在酒精中毒者中,测定了乙醇摄入量、胃肠道症状和酒精性神经病变等各种参数,并将其与胃肠道转运时间相关联。虽然胃排空总体上没有显著差异,但在23.9%的酒精中毒者中检测到胃排空异常延迟,而对照者中未检测到(P<0.005)。酒精中毒者的口至盲肠转运明显延长(P<0.001),14名酒精中毒者(37.8%)出现口至盲肠转运延迟。两组在全肠道转运方面未检测到显著差异。在酒精中毒者中,消化不良症状与胃排空延迟显著相关(P<0.006),与无腹泻的酒精中毒者相比,腹泻的酒精中毒者口至盲肠转运加快(P<0.05)。自主神经或周围神经病变的存在,以及肝硬化或腹水的存在,均与胃肠道转运时间无显著相关性。然而,每日乙醇摄入量与胃排空显著相关(P<0.005)。因此得出结论,在慢性酒精中毒者中,小肠和胃最有可能受到胃肠道转运障碍的影响,并且这些转运异常可能与胃肠道平滑肌的毒性损伤有关。