Persistent diarrhea: total gut transit time and its relationship with nutrient absorption and clinical response

The study was undertaken to better understand the role of total gut transit time (TGTT) on the absorption of nutrients in patients with persistent diarrhea. Twenty-six boys aged 3-18 months with persistent diarrhea and 25 age-matched healthy controls were studied. Their TGTT was measured with charcoal markers during their treatment with a diet made up with rice powder soya oil, glucose, and egg white. Coefficients of absorption of nutrients were estimated in a 72-h balance study. The median TGTTs in patients and controls were 5 and 11.6 h, respectively. Among the patients, the TGT correlated significantly with absorption of total energy (p less than 0.01), absorption of fat (p less than 0.01), stool frequency (p less than 0.01), and stool weight during the 1st 24 h (p less than 0.01). Coefficients of absorption of energy, fat, and carbohydrate were significantly different among the patients above or below the median transit time (5 h). None of these relationships was present among the healthy controls. The TGTT was negatively associated with the duration of clinical recovery. The results of this study suggested that intestinal transit time is an important factor for absorption of nutrients that may influence clinical recovery in patients with persistent diarrhea.