title: Gastric emptying and disease activity in inflammatory bowel disease.
abstract: BACKGROUND
  Gastric emptying (GE) is delayed in a subset of patients with inflammatory bowel disease (IBD). We have shown before that altered release of gastrointestinal hormones may contribute to GE disturbances, but overall effects of disease activity remain unclear. Thus, we aimed to evaluate GE in patients with IBD during active disease and following therapy.
  
  
  METHODS
  A total of 20 healthy subjects (HC) and 26 patients with IBD hospitalized because of an acute episode of their disease (Crohn's disease (CD) n = 13, ulcerative colitis (UC) n = 13) underwent a standardized (13) C-octanoic acid GE breath test (baseline test). Plasma glucose, cholecystokinin (CCK), peptide YY (PYY) and glucagon-like peptide-1 (GLP-1) were measured periodically throughout the test. A total of 16 patients underwent a second GE test after 3-4 months of therapy.
  
  
  RESULTS
  At baseline, nine patients with IBD had pathologically delayed GE half-time (T½ > 150 min) (P = 0·028 vs. HC). Moreover, T½ was significantly longer in the total group of patients with IBD than in HC (129 ± 12 min vs. 96 ± 7, P = 0·030). Postprandial GLP-1 responses were elevated in IBD (P = 0·002 vs. HC) and correlated with T½ (P = 0·05). Following therapy clinical activity indices and T½ were decreased in IBD (P ≤ 0·01 vs. baseline), and T½ no longer differed from HC (P > 0·5). Moreover, GLP-1 plasma levels decreased significantly (P = 0·031).
  
  
  CONCLUSIONS
  Higher disease activity in IBD is associated with prolonged GE and increased release of GLP-1. Following effective therapy, GE is accelerated and GLP-1 release decreases significantly. Thus, increased release of GLP-1 from the inflamed mucosa might contribute to GE disturbances in IBD.
authors.affiliation: Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Keller
authors.affiliation: Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Binnewies
authors.affiliation: Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany.
authors.forename: Marie
authors.initials: M
authors.lastname: Rösch
authors.affiliation: NNF Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jens
authors.initials: J
authors.lastname: Juul Holst
authors.affiliation: Department of Gastroenterology and Hepatology, Universitätsspital Basel, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Beglinger
authors.affiliation: Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany.
authors.forename: Viola
authors.initials: V
authors.lastname: Andresen
authors.affiliation: Department of Internal Medicine, Israelitic Hospital, Hamburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Layer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001944:Breath Tests; D016022:Case-Control Studies; D002766:Cholecystokinin / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000503:physiopathology*; D003424:Crohn Disease / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019894:Peptide YY / Q000378:metabolism; D019518:Postprandial Period; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1; D002766:Cholecystokinin
keywords: Disease activity; gastric emptying; hormonal regulation; hyperglycaemia; inflammatory bowel disease; motility