DUODENAL SECRETOMOTOR FUNCTION IN UNTREATED CELIAC-DISEASE

Background: The aim of the study was to characterize the epithelial tr ansport properties of the distal duodenal mucosa in untreated coeliac disease. Methods: The study was performed in 20 patients and in 22 hea lthy controls. Net fluid and bicarbonate transport was measured with a triple-lumen perfusion technique. Interdigestive motility was recorde d by manometry, and the transmural potential difference (PD) was measu red as an indicator of electrogenic anion secretion. Results: In the p atients a net fluid secretion was seen (-1.04 +/- 0.26 versus 0.12 +/- 0.11 ml/min x 10 cm in the controls; p < 0.01), and there was no sign ificant net bicarbonate absorption (5.6 +/- 3.4 versus 27.5 +/- 4.4 mu mol/min x 10 cm in the controls; p < 0.001). The epithelial transport rate varied with the interdigestive motility; a shift in the secretor y direction was seen in late phase II of the migrating motor complex ( MMC). Moreover, the MMC-related PD curve was significantly displaced i n the lumen-negative direction (p ( 0.001 versus controls). Conclusion s: The results suggest that in untreated coeliac disease, active chlor ide secretion is enhanced, and Na+/H+ exchange is reduced. This remode lled mucosa still seems to respond to neurogenic stimuli, as suggested by the presence of MMC-related changes in secretion rate.