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Published on: September 22, 2023
Characterisation of fasted state gastric and intestinal fluids collected from children
Gopal Pawar1, Eleni Papadatou-Soulou1, Julie Mason1
1School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston B15 2TT, United Kingdom.
Insights
This study characterized pediatric gastric and intestinal fluids, revealing significant inter-individual variability in pH, osmolality, and bile acid concentrations. These findings are crucial for developing pediatric drug formulations.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Pharmacokinetics
Background:
- Limited data exists on the composition of pediatric gastrointestinal fluids.
- Understanding these fluid properties is essential for pediatric drug development and formulation.
Purpose of the Study:
- To characterize the physicochemical properties of gastric and intestinal fluids in pediatric patients.
- To provide fundamental data for the development of simulated pediatric gastrointestinal media.
Main Methods:
- Collected gastric and intestinal fluid samples from 55 pediatric patients undergoing endoscopy.
- Measured pH, buffer capacity, osmolality, and bile acid concentration and composition.
Main Results:
- Gastric fluid pH ranged from 0.57 to 11.05 (median 2.50), intestinal fluid pH from 0.89 to 8.97 (median 3.27).
- Buffer capacity was similar in both fluids (median 12 mM/L/ΔpH).
- Intestinal fluid showed higher median bile acid concentration (0.178 mM) compared to gastric fluid (0.017 mM), with significant inter-individual variability observed across all parameters.
Conclusions:
- Paediatric gastrointestinal fluid composition exhibits substantial inter-individual variability.
- Further research is needed to develop accurate simulated pediatric media for drug solubility and dissolution studies.
Abstract:
Fundamental knowledge about the composition of intestinal fluids in paediatric populations is currently unavailable. This study aimed to characterise gastric and intestinal fluid from paediatric populations. Gastric and intestinal fluid samples were obtained during routine clinical endoscopy from paediatric patients at a large teaching hospital. These fluids were characterised to measure the pH; buffer capacity; osmolality; bile acid concentration and composition. A total of 55 children were recruited to the study aged from 11 months to 15 years of age where 53 gastric fluid samples and 40 intestinal fluid samples were obtained. pH values recorded ranged from pH 0.57 to 11.05 (median: 2.50) in gastric fluids and from 0.89 to 8.97 (median: 3.27) in intestinal fluids. The buffer capacity did not change significantly between gastric and intestinal fluids with median values of 12 mM/L/ΔpH for both fluids. Gastric fluid osmolality values ranged from 1 to 615 mOsm/kg, while intestinal fluid values ranged from 35 to 631 mOsm/kg. Gastric fluid bile acid concentrations ranged from 0.002 to 2.3 mM with a median value of 0.017 mM whilst intestinal fluid bile acid concentrations ranged from 0.0008 to 3.3 mM with a median value of 0.178 mM. Glycocholate; taurocholic acid; glycochenodeoxycholate and taurochenodeoxycholate were the most commonly identified bile acids within paediatric intestinal fluids. All compositional components were associated with large inter-individual variability. Further work is required to develop simulated paediatric media and to explore the impact of these media on drug solubility and dissolution.
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