Constipation-Predominant Irritable Bowel Syndrome Females Have Normal Colonic Barrier and Secretory Function

Stephanie A. Peters, Shoko Edogawa, Wendy J. Sundt, Roy B. Dyer, Daniel A. Dalenberg, Amelia Mazzone, Ravinder J. Singh, Natalie Moses, Thomas C. Smyrk, Christopher Weber, David R. Linden, Wallace K. Macnaughton, Jerrold R. Turner, Michael Camilleri, David A. Katzka, Gianrico Farrugia, Madhusudan Grover

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


OBJECTIVES:The objective of this study was to determine whether constipation-predominant irritable bowel syndrome (IBS-C) is associated with changes in intestinal barrier and secretory function.METHODS:A total of 19 IBS-C patients and 18 healthy volunteers (all females) underwent saccharide excretion assay (0.1 g 13 C mannitol and 1 g lactulose), measurements of duodenal and colonic mucosal barrier (transmucosal resistance (TMR), macromolecular and Escherichia coli Bio-Particle translocation), mucosal secretion (basal and acetylcholine (Ach)-evoked short-circuit current (Isc)), in vivo duodenal mucosal impedance, circulating endotoxins, and colonic tight junction gene expression.RESULTS:There were no differences in the in vivo measurements of barrier function between IBS-C patients and healthy controls: cumulative excretion of 13 C mannitol (0-2 h mean (s.e.m.); IBS-C: 12.1 (0.9) mg vs. healthy: 13.2 (0.8) mg) and lactulose (8-24 h; IBS-C: 0.9 (0.5) mg vs. healthy: 0.5 (0.2) mg); duodenal impedance IBS-C: 729 (65) Ω vs. healthy: 706 (43) Ω; plasma mean endotoxin activity level IBS-C: 0.36 (0.03) vs. healthy: 0.35 (0.02); and in colonic mRNA expression of occludin, zonula occludens (ZO) 1-3, and claudins 1-12 and 14-19. The ex vivo findings were consistent, with no group differences: duodenal TMR (IBS-C: 28.2 (1.9) Ω cm 2 vs. healthy: 29.8 (1.9) Ω cm 2) and colonic TMR (IBS-C: 19.1 (1.1) Ω cm 2 vs. healthy: 17.6 (1.7) Ω cm 2); fluorescein isothiocyanate (FITC)-dextran (4 kDa) and E. coli Bio-Particle flux. Colonic basal Isc was similar, but duodenal basal Isc was lower in IBS-C (43.5 (4.5) μA cm -2) vs. healthy (56.9 (4.9) μA cm -2), P=0.05. Ach-evoked Î "Isc was similar.CONCLUSIONS:Females with IBS-C have normal colonic barrier and secretory function. Basal duodenal secretion is decreased in IBS-C.

Original languageEnglish (US)
Pages (from-to)913-923
Number of pages11
JournalAmerican Journal of Gastroenterology
Issue number6
StatePublished - Jun 1 2017

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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