DuPont Andrew W, Jiang Zhi-Dong, Harold Stephen A, Snyder Ned, Galler Greg W, Garcia-Torres Francisco, DuPont Herbert L
The University of Texas Health Science Center, Houston, Tex., USA.
Digestion. 2014;89(2):119-23. doi: 10.1159/000356314. Epub 2014 Feb 6.
BACKGROUND/AIMS: The intestinal pathophysiology in irritable bowel syndrome (IBS) is largely unknown. The lactulose breath test has been used to identify small bowel bacterial overgrowth in these patients.
We studied intestinal transit in patients with IBS using of the SmartPill® (SP) wireless pH/pressure recording capsule and performed lactulose breath tests to look for physiologic abnormalities.
A total of 35/46 (76%) of the IBS patients had prolonged gastric emptying times. Constipation-predominant disease was associated with prolonged gut transit times. The mean hours ± SD for colonic transit time in the constipation group was 71.7 ± 61.1 (n = 13) compared with 22.5 ± 14.9 (n = 14) for diarrhea-predominant and 26.4 ± 21.5 (n = 20) for mixed clinical subtype (p = 0.0010). No correlation between small bowel transit time and abnormal breath hydrogen or methane excretion in the 46 combined patients with IBS was seen.
Delayed gastric emptying was identified in IBS and in some patients may contribute to at least a component of their symptoms. Constipation-predominant IBS is associated with prolonged gut transit times. Otherwise, transit abnormalities do not appear to be important in IBS. Intestinal transit did not correlate with breath test results.
背景/目的：肠易激综合征（IBS）的肠道病理生理学在很大程度上尚不清楚。乳果糖呼气试验已被用于识别这些患者的小肠细菌过度生长情况。
我们使用SmartPill®（SP）无线pH/压力记录胶囊研究了IBS患者的肠道转运情况，并进行了乳果糖呼气试验以寻找生理异常。
总共46例IBS患者中有35例（76%）胃排空时间延长。以便秘为主的疾病与肠道转运时间延长有关。便秘组结肠转运时间的平均小时数±标准差为71.7±61.1（n = 13），而腹泻为主型为22.5±14.9（n = 14），混合临床亚型为26.4±21.5（n = 20）（p = 0.0010）。在46例合并的IBS患者中，未发现小肠转运时间与异常呼气氢气或甲烷排泄之间存在相关性。
在IBS患者中发现了胃排空延迟，在一些患者中这可能至少是其症状的一个组成部分。以便秘为主的IBS与肠道转运时间延长有关。否则，转运异常在IBS中似乎并不重要。肠道转运与呼气试验结果无关。
