MC & Small Intestinal Stuff

[harvest_table]

These studies discussing small intestinal stuff may be of interest to you. Read links for entire text.

Quote:
We describe the case of a 64-year-old woman with a previous
diagnosis of celiac sprue and no clinical or histological response to gluten withdrawal......We suggest that this patient may have a separate disease entity unrelated to celiac sprue and consisting of a panintestinal
inflammatory disorder characterized by the combination of a
a chronic inflammatory infiltrate in the small and lower bowel together with a subepithelial collagenous band in the colon.
http://cat.inist.fr/?aModele=afficheN&cpsidt=14612918


Quote:
There is a recognised association between the "microscopic" forms of colitis and coeliac disease. There are a variety of subtle small intestinal changes in patients with "latent" gluten sensitivity, namely high intraepithelial lymphocyte (IEL) counts, abnormal mucosal permeability, and high levels of secretory IgA and IgM antibody to gliadin.....Small intestinal permeability was measured by the lactulose:mannitol differential sugar permeability test. Intestinal permeability was measured in eight cases and was abnormal in two and borderline in one. These abnormalities did not overlap: four of nine patients had evidence of abnormal small intestinal function. Subclinical small intestinal disease is common in the two main forms of microscopic colitis.

http://www.pubmedcentral.nih.gov/articl ... tid=500002

This one has recently published.
Quote:
Objective. Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies, indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal permeability.... Conclusions. No alterations in intestinal permeability in patients with CC could be demonstrated. Impairment of the integrity of the mucosa of the small bowel and the presence of a general dysfunction of the small intestine in patients with CC seem unlikely. Unquote.

Having problems providing a link for this last article but if I understand it's correctly it's confirming that in some cases CC can be a pan-intestinal disease but, based on this study unlikely it would impair the small bowel or effect the small intestine.

Just more stuff to digest!

Love,
Joanna

[harvest_table]

Having problems with the link for that last article. Here is the full text.

Scandinavian Journal of Gastroenterology
Publisher: Taylor & Francis
Issue: Volume 41, Number 9 / September 2006
Pages: 1044 - 1049
URL: Linking Options
DOI: 10.1080/00365520600554535

Small-bowel permeability in collagenous colitis

Signe Wildt A1, Jan L. Madsen A2, Jüri J. Rumessen A3

A1 Department of Gastroenterology, University Hospital of Copenhagen, Denmark
A2 Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, University Hospital of Copenhagen, Denmark
A3 Department of Gastroenterlogy F, Gentofte Hospital, University Hospital of Copenhagen, Denmark

Abstract:

Objective. Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies, indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal permeability. Material andmethods. Ten patients with CC and chronic diarrhoea participated in the study. Coeliac disease was excluded by small-bowel biopsy and/or serology. Intestinal permeability was assessed as urinary excretion (ratios) 2, 4 and 6 h after ingestion of 14C-labelled mannitol (14C-mannitol) and 99mTc-labelled diethylenetriamine-pentaacetic acid (99mTc-DTPA). Data were compared with the results from healthy controls. Results. No difference was found between groups in urinary excretion of 14C-mannitol and 99mTc-DTPA after 2, 4 or 6 h, respectively. Likewise, no significant differences in the 99mTc-DTPA/14C-mannitol ratios between patients and controls were detected after 2 h: 0.030 (0.008–0.130) versus 0.020 (0.007–0.030), p=0.19, after 4 h: 0.040 (0.009–0.180) versus 0.020 (0.008–0.040), p=0.14 or after 6 h: 0.040 (0.012–0.180) versus 0.020 (0.010–0.040), p=0.17. Conclusions. No alterations in intestinal permeability in patients with CC could be demonstrated. Impairment of the integrity of the mucosa of the small bowel and the presence of a general dysfunction of the small intestine in patients with CC seem unlikely.

[tex]

Hi Joanna,

Thanks for the research information. These articles seem to support my thoughts about the issue.

The last reference is a bit confusing, though. Their conclusions seem to contradict their initial claims. I can't help but wonder if something was overlooked in their project, which confounded their results. For one thing, who decided that mannitol is the medium to use, to test small intestinal permeability? Perhaps there is something that prevents it from performing as expected, in this particular situation.

Love,
Tex

[mle_ii]

Yikes, mannitol, that didn't even register. I wonder why they didn't use lactulose as from what I just read about mannitol it could have an effect on the body that might throw off their results.

Ah, here's why. Just found this:
https://www.gdx.net/home/assessments/ip/

The Intestinal Permeability Assessment directly measures the ability of two nonmetabolized sugar molecules -mannitol and lactulose-to permeate the intestinal mucosa. Mannitol is easily absorbed and serves as a marker of transcellular uptake, while lactulose is only slightly absorbed and serves as a marker for mucosal integrity. To perform the test, the patient mixes premeasured amounts of lactulose and mannitol and drinks the challenge substance. The test measures the amount of lactulose and mannitol recovered in a urine sample over the next 6 hours.

So they should have used mannitol and lactulose for both of these tests.

FWIW I'm getting this tested soon as well.

Mike