PMID: 3371722Apr 1, 1988Paper

Pathophysiological study of diarrhoea in a patient with medullary thyroid carcinoma. Evidence against a secretory mechanism and for the role of shortened colonic transit time

Gut
J C RambaudJ J Bernier

Abstract

Intubation techniques and scintigraphic studies were used to determine the origin and mechanism of diarrhoea in a patient with medullary thyroid carcinoma, high plasma immunoreactive calcitonin and normal circulating serotonin, substance P and prostaglandins E2 and F2 alpha. Normal function of the small intestine was found for the following: (a) absorption tests; (b) water and electrolyte absorption in the proximal jejunum; (c) 24 hour flow rate and composition of fluid entering the colon and (d) gastric emptying rate and small intestinal progression of a normal meal. By contrast, colonic function was markedly impaired in three ways: (a) water absorption was decreased by half; (b) as the main excreted solutes were organic acids, a large electrolyte gap was recorded in faecal water, and (c) colonic transit time of the meal marker was very short, and was in agreement with the rapid transit of ingested radioopaque markers. These data strongly suggest that decreased absorption in the colon secondary to a motor disturbance is the main mechanism of diarrhoea in this case of medullary thyroid carcinoma, while calcitonin induced small intestinal fluid secretion suggested earlier is either non-existent, or only of minor importance.

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Citations

Nov 1, 1989·The Japanese Journal of Surgery·R A Decker, S A Wells
Apr 16, 2013·Endocrine·Cosimo DuranteSebastiano Filetti
May 28, 2009·Thyroid : Official Journal of the American Thyroid Association·UNKNOWN American Thyroid Association Guidelines Task ForceSamuel A Wells
Dec 1, 1996·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·G J Sanger
Aug 12, 2015·European Journal of Internal Medicine·Angelos KyriacouAkheel A Syed
Jan 22, 2011·Journal of Cellular and Molecular Medicine·Hongguang LiuPradeep K Dudeja
Mar 27, 2015·Thyroid : Official Journal of the American Thyroid Association·Samuel A WellsUNKNOWN American Thyroid Association Guidelines Task Force on Medullary Thyroid Carcinoma
Mar 31, 2010·Journal of Clinical Gastroenterology·Ellen C Ebert
Oct 12, 2017·Critical Reviews in Food Science and Nutrition·Marco GalloUNKNOWN NIKE Group
Aug 9, 2017·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Thanh D HoangMohamed K M Shakir
Oct 4, 2018·Endocrine·Kosmas DaskalakisGregory Kaltsas

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