title: Gut transit is associated with gastrointestinal symptoms and gut hormone profile in patients with cirrhosis.
abstract: OBJECTIVE
  Liver cirrhosis is associated with increased prevalence of gastrointestinal symptoms, insulin resistance, and altered gut transit. We aimed to assess the prevalence of gut transit abnormalities in patients with cirrhosis, compared with healthy controls, and to evaluate the relation of gut transit with gastrointestinal symptoms and postprandial glucose and hormone profiles.
  
  
  METHODS
  Half gastric emptying, small bowel residence, and colonic filling times were measured with a validated radiologic procedure in 42 consecutive patients with cirrhosis. In a subgroup of 25 patients, gastrointestinal symptoms were evaluated by using a validated questionnaire and a caloric satiation test. Postprandial glucose, insulin, leptin, ghrelin, glucagon-like peptide 1, and PYY responses were also studied. Eighty-three healthy subjects served as controls for the transit studies and 10 for the hormone analyses.
  
  
  RESULTS
  Of patients with cirrhosis, 24% had delayed gastric emptying and 38% had prolonged small bowel transit (P < .05 compared with controls). Delayed gastric emptying was related to postprandial fullness and prolonged small bowel transit to diarrhea and abdominal pain (P < .05 for all). The patients with cirrhosis had increased postprandial glucose, insulin, and glucagon-like peptide 1 responses and reduced postprandial ghrelin. Delayed gastric emptying was related to increased postprandial glucose and reduced postprandial ghrelin. Prolonged small bowel transit was related to increased postprandial glucose and insulin and reduced postprandial ghrelin.
  
  
  CONCLUSIONS
  A high proportion of patients with cirrhosis exhibit delayed gastric emptying or small bowel transit, which is related to gastrointestinal symptoms. Postprandial hyperglycemia, hyperinsulinemia, and hypoghrelinemia might be linked to delayed gut transit in cirrhosis.
authors.affiliation: Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden. kalvag@hotmail.com
authors.forename: Evangelos
authors.initials: E
authors.lastname: Kalaitzakis
authors.forename: Riadh
authors.initials: R
authors.lastname: Sadik
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Holst
authors.forename: Lena
authors.initials: L
authors.lastname: Ohman
authors.forename: Einar
authors.initials: E
authors.lastname: Björnsson
mesh_terms: D000368:Aged; D001774:Blood Chemical Analysis; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005767:Gastrointestinal Diseases / Q000503:physiopathology*; D005768:Gastrointestinal Hormones / Q000097:blood*; D041981:Gastrointestinal Tract / Q000000981:diagnostic imaging; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011795:Surveys and Questionnaires
chemical_list: D005768:Gastrointestinal Hormones