Endothelin-1 is a candidate mediating intestinal dysmotility in patients with acute pancreatitis

We studied whether gastrointestinal transit was disturbed during acute panc reatitis and attempted to identify which mechanisms might be involved in ac ute pancreatitis. Using a noninvasive hydrogen breath test to determine the orocecal transit time, 24 patients with the clinical diagnosis of acute pa ncreatitis were enrolled into the intestinal motility study. Orocecal trans it time was measured twice in all patients: once at the acute stage and onc e at recovery. Blood was obtained to study amylase, lipase, C-reactive prot ein, erythrocyte sedimentation rate, and endothelin-l and nitrate/nitrite l evels. Orocecal transit times measured at the acute stage were significantl y delayed compared with those at recovery (mean values +/- SEM, 130.0 +/- 9 .0 vs 80.8 +/- 7.4 min, P < 0.001). Plasma endothelin-1 levels exhibited a positive correlation with orocecal transit times in the acute stage (r = 0. 509, P = 0.011). The percentages of altered orocecal transit times also cor related with the percentages of altered plasma endothelin-1 levels (r = 0.7 51, P < 0.001). Plasma nitrate/nitrite levels significantly decreased at th e acute stage compared with those at recovery (5.25 +/- 0.82 vs 10.20 +/- 1 .24 mu M, P < 0.05). We conclude that intestinal transit is delayed in pati ents with mild to moderate acute pancreatitis. Elevated plasma endothelin-1 levels in the acute stage may be one mechanism mediating intestinal dysmot ility.