Rao S S, Read N W, Brown C, Bruce C, Holdsworth C D
Clinical Research Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Gastroenterology. 1987 Nov;93(5):934-40. doi: 10.1016/0016-5085(87)90554-3.
The transit of a radiolabeled meal through the gastrointestinal tract and stool output were measured in 62 patients with ulcerative colitis, subdivided according to the activity and extent of their disease. The results were compared with those from 20 sex-matched normal subjects. Mouth-to-cecum transit was significantly slower than normal in all patient groups although gastric emptying was normal. Whole gut transit was not accelerated in any group of patients. An abdominal x-ray taken 48 h after ingesting the meal showed that patients with active colitis had proximal colonic stasis, whereas transit through the rectosigmoid region was rapid. Stool weights and frequencies were higher in patients with active colitis than in patients with quiescent disease. Patients with active colitis also passed smaller amounts of stool during each bowel movement, suggesting that they experienced a desire to defecate at lower rectal volumes. These results indicate that (a) diarrhea in ulcerative colitis is associated with rectosigmoid irritability rather than rapid transit and (b) caution should be used when treating active colitis with antidiarrheal drugs that could further retard proximal colonic transit.
对62例溃疡性结肠炎患者进行了放射性标记餐通过胃肠道的转运及粪便排出量的测定，这些患者根据疾病的活动程度和范围进行了细分。将结果与20名性别匹配的正常受试者的结果进行了比较。尽管胃排空正常，但所有患者组从口腔到盲肠的转运均明显慢于正常情况。任何一组患者的全肠道转运均未加速。摄入餐食48小时后进行的腹部X光检查显示，活动性结肠炎患者近端结肠有淤滞，而通过直肠乙状结肠区域的转运很快。活动性结肠炎患者的粪便重量和频率高于静止期疾病患者。活动性结肠炎患者每次排便时排出的粪便量也较少，这表明他们在直肠容量较低时就有排便欲望。这些结果表明：（a）溃疡性结肠炎中的腹泻与直肠乙状结肠易激惹有关，而非快速转运；（b）在用可能进一步延缓近端结肠转运的止泻药治疗活动性结肠炎时应谨慎。
