Proximal and distal gut hormone secretion in slow transit constipation

Background It has been suggested that slow transit constipation might be pa rt of a panenteric disorder. Gastrointestinal peptides are involved in regu lation of motility. Design In the present study we have evaluated whether plasma levels of prox imal and distal gut hormones in the fasting state, and for 120 min after a solid meal in 29 patients with slow transit constipation are different from those obtained from 29 healthy controls. Plasma levels of the gut hormones cholecystokinin, gastrin, pancreatic polypeptide, motilin, neurotensin and peptide YY were determined using sensitive radioimmunoassays. In the patie nt group, oro-caecal transit time was determined by means of the hydrogen b reath test on a separate test day. The results of transit were related with postprandial hormone secretion. Results Fasting plasma levels of cholecystokinin and pancreatic polypeptide were significantly (P < 0.05) increased in constipated patients. Postprand ially, secretion of pancreatic polypeptide and cholecystokinin was signific antly (P < 0.05) increased in the patients, while secretion of peptide YY w as significantly (P < 0.05) reduced. Plasma motilin levels were not differe nt between patients and controls. Altered postprandial hormone secretion wa s mainly observed in constipated patients with prolonged oro-caecal transit time. Conclusions In patients with slow transit constipation, fasting and postpra ndial secretion of proximal gut hormones apart from motilin is increased an d of distal gut hormones decreased, especially in those with severely delay ed intestinal transit.