Plasma cholecystokinin, plasma peptide YY and gallbladder motility in patients with slow transit constipation: Effect of intestinal stimulation

Background/Aim: Because cholecystokinin and peptide YY are gut hormones wit h potent effects on gastrointestinal motility, we determined whether abnorm alities of cholecystokinin and peptide YY exist in slow transit constipatio n. Methods: Plasma concentrations of these hormones before, during and afte r intraduodenal infusion of a liquid meal in 21 patients with slow transit constipation were compared with the results in 8 healthy controls. Results: Pasting levels of plasma cholecystokinin (3.1 +/- 0.2 vs. 2.4 +/- 0.2 pM; p = 0.02) were higher in patients. Basal plasma peptide YY (11.4 +/- 1.4 vs . 8.9 +/- 0.7 pM; p = 0.1) tended to be higher in patients. After the meal (60-90 min), incremental cholecystokinin (p < 0.05), but not peptide YY, wa s significantly higher in patients. During intraduodenal infusion of the me al (0-60 min), incremental plasma cholecystokinin (251 +/- 20 pM. min) and peptide YY (1,146 +/- 186 pM.min) in patients were almost similar to contro l values (262 +/- 22 and 901 +/- 166 pM.min). Gallbladder volumes before, d uring and after the meal were not different between the 2 groups. Gastric e mptying of a solid meal was delayed in the majority of patients (12 of 18). Abnormalities of plasma cholecystokinin were observed only in patients wit h delayed gastric emptying. Conclusion: Plasma levels of cholecystokinin ar e elevated in the fasting state and decrease more slowly after stimulation, but maximum release in response to intestinal nutrients is not altered in patients with slow transit constipation. The abnormality seems to be confin ed to a subgroup of patients with delayed gastric emptying. Copyright (C) 2 000 S. Karger AG. Basel.