Small Bowel Transit Time in Ulcerative Colitis Patients and Gastrectomy Patients

Song, In Sung; Choi, Kyoo Wan; Kim, Chung Yong; Jung, Hyun Chae; Lee, Dong Ho; Kim, Tae Ho; Chang, Dong Kyung; Kim, You Sun; Jung, Jun Oh; Byun, Jeong Sik; Lee, Kook Lae

Abstract

BACKGROUND AND AIMS: Small bowel transit time (orocecal transit time) is an important parameter of intestinal function. The lactulose hydrogen breath test is a relatively simple, sensitive and noninvasive method for measuring orocecal transit time. The small bowel transit time is known to be influenced by many factors such as psychological stress and menstrual cycle. However, it is not obvious how resection or diseases of the stomach and colon affect on small bowel transit time. We compared orocecal transit time of patients with ulcerative colitis and who had received gastrectomy with that of healthy controls.
METHODS
We investigated orocecal transit time of 18 healthy persons, 12 patients who had received gastrectomy, 11 patients with active ulcerative colitis and 14 patients with inactive ulcerative colitis. After overnight fasting, lactulose 13 g with water 100 cc was ingested. Then, end-expiratory gas was collected every 15 minutes for 4 hours, The amount of hydrogen in the collected gas samples was measured by Trace Gas Analyzer (Quintron),
RESULTS
For normal Korean adults, the mean of orocecal transit time was 95+/-18.5 minutes (range: 60-135). The orocecal transit time in patients who had received gastrectomy and patients with ulcerative colitis is longer than that of healthy controls (p<0.01). No statistical difference was found between patients with active and inactive ulcerative colitis. However, the orocecal transit time in active stage patients was prolonged by 35 minutes.
CONCLUSIONS
The lactulose hydrogen breath test is a valuable rnethod to assess orocecal transit time in patients with variable gastrointestinal diseases. The underlying mechanism for these results are unclear, but it is suggested that some regulating factors of gastrointestinal motility are changed due to gastrectomy and inflammation of the colon. Further investigation is needed to elucidate the mechanism of the change of orocecal transit time.