Shafer R B, Prentiss R A, Bond J H
Gastroenterology. 1984 May;86(5 Pt 1):852-5.
Diarrhea and malabsorption are common manifestations of hyperthyroidism, whereas constipation or obstipation frequently occur in hypothyroidism. Abnormalities of gastrointestinal motility have been proposed as the primary cause of these complaints, but documentation has been conflicting and largely limited to observations of the transit time of a barium meal. We studied gastrointestinal transit time in fasting patients with thyroid dysfunction using the pulmonary excretion of H2 after the ingestion of a nonabsorbable carbohydrate, lactulose, as an indicator of the rate of transit to the colon. Mean transit time of 10 hyperthyroid patients (29 +/- 4.0 min) was significantly less than that of 42 healthy controls (72 +/- 3.7 min, p less than 0.001), and of 6 hyperthyroid patients when they became hypothyroid after treatment (80 +/- 11.0 min, p less than 0.05). Transit time decreased significantly when hypothyroid patients were given thyroid replacement (p less than 0.01). These findings support the hypothesis that abnormal gut motility may be the primary cause of the diarrhea and malabsorption of hyperthyroidism, and the constipation and obstipation commonly seen in hypothyroidism.
腹泻和吸收不良是甲状腺功能亢进的常见表现，而便秘或肠梗阻则常发生于甲状腺功能减退症。胃肠动力异常被认为是这些症状的主要原因，但相关记录存在矛盾，且很大程度上仅限于对钡餐通过时间的观察。我们使用摄入不可吸收碳水化合物乳果糖后肺部氢气的排泄情况作为结肠转运速率的指标，对甲状腺功能障碍的空腹患者进行了胃肠转运时间研究。10例甲状腺功能亢进患者的平均转运时间（29±4.0分钟）显著短于42例健康对照者（72±3.7分钟，p<0.001），也短于6例甲状腺功能亢进患者治疗后转为甲状腺功能减退时的平均转运时间（80±11.0分钟，p<0.05）。给予甲状腺功能减退患者甲状腺替代治疗后，转运时间显著缩短（p<0.01）。这些发现支持了以下假说：肠道动力异常可能是甲状腺功能亢进症腹泻和吸收不良以及甲状腺功能减退症常见的便秘和肠梗阻的主要原因。
