Gastroduodenal Symptoms in Inflammatory Bowel Disease Are Correlated with Gastric Emptying and Serum Levels of Active Ghrelin

Abstract

Background: Inflammatory bowel disease (IBD) is associated with delay in gastric emptying, increase in ghrelin, and decrease in leptin. The aim was to investigate the correlation between gastroduodenal (GD) symptoms, gastric emptying, and serum levels of active ghrelin and leptin in IBD. Twenty-seven IBD patients and 26 healthy volunteers were asked to complete the Porto Alegre Dyspeptic Symptoms Questionnaire. A gastric emptying test for solids was performed using a C13 octanoic acid breath test. During this test, serum samples were collected for measuring active ghrelin and leptin concentrations by radioimmunoassay. Summary: Patients with IBD demonstrated delayed gastric emptying compared with healthy volunteers. In patients with GD symptoms, the delay in gastric emptying was more pronounced, and there were significant correlations of satiety and vomiting with gastric emptying. Basal leptin, but not active ghrelin, increased in patients with GD symptoms compared with patients without these symptoms. There were negative correlations between basal active ghrelin with total Porto Alegre score and epigastric pain in IBD patients with GD symptoms. Key Messages: In IBD, satiety and vomiting were associated with delay in gastric emptying. Conversely, epigastric pain had a negative correlation with active ghrelin. Our results suggest that different pathophysiological mechanisms contribute to GD symptoms in IBD.

Helicobacter Pylori cagA+ Genotype is Associated With Consumption of Untreated Drinking Water in North-Eastern Brazil

“…This study identified a prevalence of 52.7% H. pylori infection in patients with dyspepsia attending a public health clinic that provides care primarily to low-income people of the same ethnic origin. These data are similar to infection rates observed in less-developed economies of the world (Kotilea et al, 2019) and differ from the prevalence rates found in southern and south-eastern Brazil, which are areas with the best socioeconomic and healthcare conditions in the country (Sales et al, 2019; Toscano et al, 2018).…”

“…There are relevant differences in the prevalence of H. pylori infection within Brazil. Rates vary from 82% in the northern cities (Reis Júnior et al, 2012), 79% in the northeast (Barbosa et al, 2018), 35% in the southwest (Toscano et al, 2018), and 30% in the south (Sales et al, 2019). These differences probably reflect the different levels of urbanization, sanitation, access to clean water, and community socioeconomic status in these regions (Hooi et al, 2017).…”

Potential role of ghrelin in the regulation of inflammation

“…In addition, high serum levels of ghrelin have been reported in patients with inflammatory bowel diseases and experimental colitis 104 . Some researchers confirm that the upregulation of ghrelin is an attempt to counter tissue damage following intestinal inflammation; damage may stimulate the secretion of endogenous ghrelin 105 .…”

“…In addition, high serum levels of ghrelin have been reported in patients with inflammatory bowel diseases and experimental colitis. 104 Some researchers confirm that the upregulation of ghrelin is an attempt to counter tissue damage following intestinal inflammation; damage may stimulate the secretion of endogenous ghrelin. 105 Coincidentally, a prospective clinical study in China demonstrated that serum ghrelin was negatively associated with esophageal and gastric cancer, implying the potential role of ghrelin as a marker of gastric mucosal alterations in upper gastrointestinal cancers.…”

Impact of Obesity on the Course of Management of Inflammatory Bowel Disease—A Review

“…Ghrelin attenuates leptin-induced proinflammatory responses in macrophages and T cells, causing a reduction in the concentration of proinflammatory cytokines (including TNF-α, IL-1, IL-6, and IL-8) and lowering the secretion of leptin in the gastrointestinal tract [ 159 ]. Expression of ghrelin in the course of IBD turned out to be significantly higher in comparison to the controls [ 160 , 161 ]. In a model of TNBS-induced murine colitis, intraperitoneal administration of exogenous ghrelin improved the general outcome without an impact on PPAR-γ expression [ 162 ].…”