Gastric emptying of realistic meals with and without gluten in patients with coeliac disease. Effect of jejunal mucosal recovery.
BACKGROUND
Few data are available on disturbed gastric emptying in patients with coeliac disease. The aims of the study were to investigate (a) the presence of delayed gastric emptying: (b) the acute effect on gastric emptying of gliadin; and (c) the effect of jejunal recovery on gastric emptying of meals with or without gluten in such patients.


METHODS
We measured gastric emptying of two meals in 16 patients with coeliac disease; one meal contained gliadin. Results were compared with those obtained in 24 controls. In 12 patients, both measurements were repeated after mucosal recovery. Statistical analysis was performed using the analysis of variance for repeated measurements and Student's t test. Mean +/- 1 s(mean) (standard error of the mean) are shown.


RESULTS
No difference was found in fasting and in maximal antral sections after the two meals. On entry, gastric emptying was significantly (P < 0.001) delayed compared to controls both after the meal containing gluten (326.9 +/- 12.4 min versus controls 213.5 +/- 11.5) and after the gluten-free meal (315.3 +/- 16.7 min). After jejunal recovery, emptying of the meal containing gluten remained unchanged (337 +/- 18.9 min), whereas emptying of the gluten-free meal was significantly shortened (280.6 +/- 10.5 min; P < 0.001).


CONCLUSIONS
In coeliac disease there is an impairment of gastric emptying which is at least partially reversible. This suggests either an immunological disorder or that unabsorbed meal constituents are responsible for an ileal-brake effect.
Benini
L
L
Dept. of Gastroenterology, Rehabilitation Hospital of Valeggio sM, University of Verona, Italy. ckbenini@tin.it
Sembenini
C
C
Salandini
L
L
Dall'O
E
E
Bonfante
F
F
Vantini
I
I
D000293:Adolescent; D000328:Adult; D002446:Celiac Disease / Q000000981:diagnostic imaging / Q000178:diet therapy / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying; D005769:Gastrointestinal Motility; D005903:Gliadin / Q000008:administration & dosage; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography
D005983:Glutens; D005903:Gliadin