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Mechanisms of diarrhea
1Division of Gastroenterology, Department of Medicine, School of Medicine, Harborview Medical Center, University of Washington School of Medicine, 325 Ninth Avenue, Box 359773, Seattle, WA 98104, USA. surawicz@u.washington.edu
Current Gastroenterology Reports
|June 10, 2010
Summary
Diarrhea, a global health issue, is being studied for its complex causes. Research reveals insights into intestinal absorption, neurotransmitter roles in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), and potential therapies.
Area of Science:
- Gastroenterology
- Physiology
- Pathophysiology
Background:
- Diarrhea is a significant global health challenge, particularly in underdeveloped regions.
- Intestinal absorption is a complex physiological process with implications for various gastrointestinal illnesses.
- The roles of the enteric nervous system and neurotransmitters in diarrhea pathogenesis are under active investigation.
Purpose of the Study:
- To explore new insights into the normal physiology and pathophysiology of diarrhea.
- To investigate the role of the enteric nervous system and neurotransmitters in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS).
- To understand the mechanisms of diarrhea to develop novel therapeutic strategies.
Main Methods:
- Analysis of ileal and sigmoid biopsies from IBD patients to assess epithelial sodium and fluid transport.
- Physiological studies in humans to investigate primary bile acid malabsorption.
- Examination of zinc's effect on intracellular human enterocyte ion secretion in infectious diarrhea.
Main Results:
- IBD patients exhibit altered transepithelial sodium and fluid transport due to decreased expression of key epithelial sodium channels (NHE3, NHERF-1, NHE1).
- This alteration in channel expression impacts electroneutral sodium chloride (NaCl) absorption, potentially contributing to diarrhea in IBD.
- Primary bile acid malabsorption, possibly due to abnormal feedback mechanisms leading to increased bile salts, may cause watery diarrhea.
Conclusions:
- Altered epithelial sodium channel expression is a contributing factor to diarrhea in IBD.
- Bile acid malabsorption presents a potential mechanism for watery diarrhea.
- Understanding basic mechanisms of ion secretion and absorption is crucial for developing new diarrhea therapies, including the role of zinc.
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