Objective
To determine if constipation predominant IBS (IBS-C) is associated with changes in intestinal barrier and secretory function.
Design
19 IBS-C patients and 18 healthy volunteers (all females) underwent saccharide excretion assay (0.1 g 13C mannitol and 1 g lactulose), measurements of duodenal and colonic mucosal barrier (transmucosal resistance (TMR), macromolecular and E. coli Bio-Particle translocation), mucosal secretion (basal and ACh evoked short circuit current, Isc), in vivo duodenal mucosal impedance, circulating endotoxins and colonic tight junction gene expression.
Results
There were no differences in the in vivo measurements of barrier function between IBS-C and healthy: cumulative excretion of 13C mannitol (0–2 hr mean (SEM); IBS-C: 12.1 (0.9) mg vs healthy: 13.2 (0.8) mg) and lactulose (8–24 hr; IBS-C: 0.9 (0.5) mg vs healthy: 0.5 (0.2) mg); duodenal impedance IBS-C: 729 (65) Ω vs healthy: 706 (43) Ω; plasma mean endotoxin activity level IBS-C: 0.36 (0.03) vs healthy: 0.35 (0.02); and in colonic mRNA expression of occludin, ZO 1–3, and claudins 1–12, 14–19. Ex vivo findings were consistent, with no group differences: duodenal TMR (IBS-C: 28.2 (1.9) Ω*cm2 vs healthy: 29.8 (1.9) Ω*cm2) and colonic TMR (IBS-C: 19.1 (1.1) Ω*cm2 vs healthy: 17.6 (1.7) Ω*cm2); FITC Dextran (4 kDa) and E. coli Bio- Particle flux. Colonic basal Isc was similar, however, duodenal basal Isc was lower in IBS-C (43.5 (4.5) µA*cm2) vs healthy (56.9 (4.9) µA*cm2), p=0.05. ACh evoked ΔIsc was similar.
Conclusions
Females with IBS-C have normal colonic barrier and secretory function. Basal duodenal secretion is decreased in IBS-C.