Scintigraphic demonstration of lactulose-induced accelerated proximal colon transit

Barrow, L.; Steed, K.P.; Spiller, Robin C.; Watts, Peter; Melia, Colin D.; Davies, Martyn C.; Wilson, Clive G.

doi:10.1016/0016-5085(92)91500-4

Cited by 46 publications

(28 citation statements)

References 24 publications

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“…Under these conditions, OCTTs differed between 70 and 205 min (Heine, Mohr and Münch, 1996;Wutzke et al, 1996). Other conventional methods for evaluation of OCTTs are based on radiographic and scintigraphic methods using barium meals, 111 In-labelled plastic particles, [ 14 C]xylose, [ 14 C]lactulose and [ 99m Tc]DTPA (Barrow et al, 1992;Ghoos et al, 1993;Hirakawa et al, 1988;King and Toskes, 1986;Madsen et al, 1991;Pressman et al, 1987;Sciarretta et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

“…Other conventional methods for the determination of OCTT are based on radiographic and scintigraphic methods using 111 In-labelled plastic particles, [ 14 Barrow et al, 1992;Hirakawa et al, 1988;Madsen et al, 1991;Pressman et al, 1987;Sciarretta et al, 1994). For ethical reasons, invasive or radioactive methods for OCTTmeasurements are not justificable, especially in childhood and pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of oro-coecal transit time: a comparison of the lactose-[13C, 15N]ureide 13CO2- and the lactulose H2-breath test in humans

et al. 1997

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Objective:The lactulose H 2 -breath test is the most widely used non-invasive approach for evaluation of orocoecal transit time (OCTT). In the present study, doubly-labelled lactose-[ 13 C, 15 N]ureide (DLLU) was synthesized to investigate the OCTT in comparison to the conventional lactulose H 2 -breath test. Additionally, the bacterial breakdown rate (BBR) and rate of elimination and the metabolic pathways of the cleavage products of DLLU ( 13 CO 2 , [ 15 N]urea, and 15 NH 3 ) were investigated. Design and subjects: In a first study, DLLU was administered as a single oral-pulse-labelling (dosage: one gram) either without and after pretreatment of five grams of unlabelled lactoseureide (LU) on the day prior to the study to twelve healthy adult volunteers after breakfast. Breath and urine were collected in one and two hourintervals, respectively, over a one-day period. 13 C-enrichment in breath as well as 15 N-enrichment in urine fractions were measured by continuous flow-isotope ratio mass spectrometry (CF-IRMS). In a second study, lactulose was administered to the same subjects (dosage: ten grams). Breath was collected in quarter, half and one hour-intervals over a ten hour-period. Hydrogen concentration in breath was analysed using an electrochemical detector. Results:The comparison of the lactose-[ 13 C]ureide 13 CO 2 -breath test and the lactulose H 2 -breath test showed that the mean increase of the 13 C-enrichment in CO 2 occurred 1.18 h later than the mean increase of H 2 in breath. The resulting OCTTs derived from the two methods were 3.02 1.7 h (P < 0.01), respectively. The 15 N-enrichment of urinary urea and ammonia without and after pretreatment with LU started between two and three hours after DLLUadministration. The cumulative percentage urinary excretion of the 15 N-and 13 C-tracer was 29.9% and 13.6% respectively, and was slightly increased after LU-pretreatment to 32.1% and 14.6% of the dose administered. A total of 35.2% of the 13 C was found to be exhaled and remained approximately constant after LU-pretreatment (36.2%). Conclusions: The use of the lactulose H 2 -breath test for evaluation of the OCTT showed a statistically significant shortening of 1.18 h in comparison to the lactose-[ 13 C]ureide 13 CO 2 -breath test in healthy adults. The most important limitations of the lactulose H 2 -breath test are its low specificity and sensitivity due to dosedependent accelerations of OCTT, interfering H 2 -rise from malabsorbed dietary fibre and H 2 -non-producers. In contrast, our lactose-[ 13 C]ureide 13 CO 2 -breath test was confirmed to avoid these disadvantages and to yield reliable results. This test is recommended especially if higher sensitivity and specificity is required, if IRMStechnique is available and if lactulose H 2 -tests lead to insufficient results.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of oro-coecal transit time: a comparison of the lactose-[13C, 15N]ureide 13CO2- and the lactulose H2-breath test in humans

et al. 1997

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“…Such discrepancy may be because of the small number of volunteers included in our study (type II error) or to the higher dose of lactulose −20 to 40 g/day – used by Barrow et al. 23 which induced diarrhoea in all subjects.…”

Section: Discussionmentioning

confidence: 99%

“…In conclusion, the results of our study as well as other previous experiments 9, 23 show that low‐dose lactulose, compared to low‐dose PEG, exerts an additional motor effect on the AC at therapeutic dose. As PEG and lactulose differ by their fermentative capacity, our results support an additional stimulating effect of bacterial fermentation on proximal colonic transit.…”

Section: Discussionmentioning

confidence: 99%

Effects of therapeutic doses of lactulose vs. polyethylene glycol on isotopic colonic transit

Jouët¹,

Sabaté²,

Flourié³

et al. 2008

Aliment Pharmacol Ther

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“…To fully exploit the transit time of a typical oral CR device (12–20 h),9 adequate colonic absorption, solubility, and stability of the formulation to precipitation, and a sufficiently low dose size are key requirements 8. It is now recognized that the markedly slower rate of material transit in the colon—11 to 12 h in the proximal colon9,10 compared with only 3–4 h in the small intestine11—permits drugs to stay in contact with the colonic mucosa for a longer time than in the small intestine, and thus greatly increases the total absorption within this compartment. In addition, the absorptive capacity of the colon has been shown to be high for highly lipid‐soluble compounds12,13 despite lower absorptive area, lower mesenteric blood flow, lower paracellular pore size, and reduced carrier mediated transport capacity for improving bioavailability 14…”

Section: Introductionmentioning

confidence: 99%

Preclinical Assessment of the Feasibility of Applying Controlled Release Oral Drug Delivery to a Lead Series of Atypical Antipsychotics

Eichenbaum

Pollock-Dove²,

Nguyen³

et al. 2006

Journal of Pharmaceutical Sciences

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Scintigraphic demonstration of lactulose-induced accelerated proximal colon transit

Cited by 46 publications

References 24 publications

Evaluation of oro-coecal transit time: a comparison of the lactose-[13C, 15N]ureide 13CO2- and the lactulose H2-breath test in humans

Evaluation of oro-coecal transit time: a comparison of the lactose-[13C, 15N]ureide 13CO2- and the lactulose H2-breath test in humans

Effects of therapeutic doses of lactulose vs. polyethylene glycol on isotopic colonic transit

Preclinical Assessment of the Feasibility of Applying Controlled Release Oral Drug Delivery to a Lead Series of Atypical Antipsychotics

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