Gut 2002;50(Suppl II):A1–A125 A1 Abstracts................................................................................................ Gut: first published as 10.1136/gut.50.suppl_2.a71 on 1 April 2002. Downloaded from Neurogastroenterology/ Abstract 002 IBSinat Concordant least one affected Discordant Casewise Motility free papers 001–011 twin (pairs) pairs pairs concordant MZ 274 45 (16%)* 229 (84%) 90/319 (28%)* 001 DOES INFECTIOUS DIARRHOEA (ID) PREDISPOSE DZ 273 46 (17%) 227 (83%) 92/319 (29%) PEOPLE TO FUNCTIONAL GASTRO-INTESTINAL Total 547 91 456 DISORDERS (FGIDS)? A PROSPECTIVE COMMUNITY CASE-CONTROL STUDY *p=NSversus DZ twins. S.D. Parry, J.R. Barton, M.R. Welfare. Northumbria Division, University of Newcastle Faculty of Medicine, North Tyneside Hospital, Rake Lane, North was defined on the basis of the Rome II criteria as abdominal pain for Shields NE29 8NH, UK at least 12 weeks in the last year with two of: relief with defaecation/ change in bowel frequency with pain/change in bowel consistency Introduction: Previous studies, many uncontrolled, suggest 4 to 32% with pain. of people develop irritable bowel syndrome (IBS) after ID. Little infor- Results: 5032 respondents (56% response rate), including 1878 mation is available on the development of other FGIDs after ID. evaluable twin pairs. 892 MZ pairs (82 male, 810 female, median Aim: To determine if patients with stool culture confirmed bacterial age 53 (range 19–81) years) and 986 DZ pairs (69 male, 917 diarrhoea were more likely to develop gut symptoms consistent with a female, age 54 (20–82) years). The prevalence of IBS among the twin diagnosis of IBS, functional dyspepsia or functional diarrhoea at 3 pairs was 638/3756 (17%). There was no significant difference in and 6 month follow up compared with community controls. casewise concordance rates in the MZ and DZ twins (see table). Methods: A prospective community-based case-control study over Conclusion: This study suggests that genetic factors do not contrib- one year. Subjects with stool positive bacterial infectious diarrhoea ute substantially to the aetiology of IBS. and control subjects from the same primary care practice were invited to participate. The presence or not of IBS, functional dyspepsia or functional diarrhoea was diagnosed at the start and at follow up using 003 ENDOGENOUS CHOLECYSTOKININ MODULATES self-complete Rome II modular questionnaires. The diagnosis of a TOLERANCE TO AN INTRAGASTRIC LIQUID LOAD BY baseline FGID excluded subjects from continuing. There were 128 AN EFFECT ON GASTRIC EMPTYING IN HUMANS cases and 219 community controls eligible and who consented to par- 1 1 2 ticipate. S. Lal, J. McLaughlin, M. D’Amato , G. Giampaolo , G.J. Dockray ,A. 2 1 Results: At follow up there was a higher incidence of FGIDs in the Varro , D.G. Thompson. Hope Hospital, Salford; Rotta Research Labora- 2 cases compared with controls, mainly due to a higher incidence of IBS tory, Monza, Italy; Physiology Laboratory, Liverpool University, UK (see table). There was no difference in the incidence of functional dys- pepsia between cases and controls. The role of CCK in human eating behaviour is unclear. Exogenous Conclusions: IBS and functional diarrhoea is diagnosed more fre- CCK reduces food intake, but a similar role for endogenous CCK is http://gut.bmj.com/ quently in people at three and six-month follow up after an episode of not established. Fatty acid release of CCK is chain length sensitive: stool positive bacterial diarrhoea compared with community controls dodecanoic acid (C12) releases CCK but decanoic acid (C10) does despite careful exclusion of people with pre-existing FGIDS and adds not. We have shown previously that C12 reduces tolerance to an further support for the concept of post-infectious IBS. intragastric liquid load to a greater degree than C10 (Lal 2001 Gas- troenterology 120: A710). Aim: To determine whether the effect of C12 on tolerance to an 002 GENETIC INFLUENCES IN IRRITABLE BOWEL intragastric liquid load is (a) mediated by an effect on gastric empty- SYNDROME: A TWIN STUDY ing, and (b) is blocked by Dexloxiglumide, a CCK-1 receptor antago- on September 30, 2021 by guest. Protected copyright. 1 3 2 3 1 nist. I. Mohammed , L. Cherkas , S.A. Riley , T.D. Spector , N.J. Trudgill . Methods: (a) Vehicle (250 ml PBS/Tween-80) alone or with 0.1M 1Sandwell General Hospital, West Midlands; 2Northern General Hospital, 3 C10 or C12 was infused into the stomach of 8 healthy volunteers in a Sheffield; Twin Research Unit, St.Thomas’ Hospital, London, UK randomised manner after an overnight fast. 20 minutes later, water was infused into the stomach at 200 ml/min to maximum volume tol- Background: Aggregation of irritable bowel syndrome (IBS) in fami- erated. Gastric contents were then aspirated. (b) 8 subjects were ran- lies of patients with IBS has recently been described. This may be due domised in a double-blind, Latin square design to receive either i.v. to learned responses to abdominal symptoms or a significant genetic dexloxiglumide (Dex; 5–15 mg/kg/h) or saline (Sal) and either intra- contribution to the visceral hypersensitivity of patients with IBS. We gastric vehicle (Veh) or C12 followed by water infusion. Data are have therefore studied IBS symptoms in monozygotic (MZ) (100% of mean±SEM (ml) compared by ANOVA followed by post hoc multiple genes shared) and dizygotic (DZ) (approximately 50% of genes comparison tests as appropriate. shared) twins to assess the contribution of genetic factors to IBS. Results: (a) Subjects tolerated more water following vehicle Methods: 4480 unselected twin pairs from a national volunteer (1481±220) and C10 (1400±227) than C12 (925±173; p<0.05 vs. twin register were asked to complete a validated questionnaire. IBS C10 & veh), confirming previous results. There was no difference in Abstract 001 3 months 6 months FGID Case ControlOdds Ratio (CI) Case Control Odds Ratio (CI) IBS Yes 18 4 9.8 (3.2–29.9) 18 4 10.1 (3.3–30.7) IBS No 90 197 90 202 F Diar Yes 9 2 9.1 (1.9–42.7) 6 0 Lower limit CI for OR F Diar No 99 199 102 206 is 2.32 F Dys Yes 4 4 1.9 (0.5–7.7) 3 2 2.9 (0.5–17.7) F Dys No 104 197 105 204 www.gutjnl.com A2 BSG abstracts the volume of gastric contents aspirated at the end of the infusion mmHg (15, 199) mmHg v 238 mmHg (231, 365) mmHg) or duode- period following any of the test meals (veh: 1045±162; nal (92 mmHg (55, 207) mmHg v 251 mmHg (120, 355) mmHg) C10:1071±153; C12:1065±147), indicating that tolerance was lim- motility being significantly affected. By the 3rd hour there were no sig- Gut: first published as 10.1136/gut.50.suppl_2.a71 on 1 April 2002. Downloaded from ited by intragastric capacity, which in turn is determined by gastric nificant differences in either antral (56 mmHg (11, 230) mmHg v 143 emptying. (b) Dex abolished the reduction in water tolerance induced mmHg (11, 338) mmHg), pyloric (18 mmHg (7, 42) mmHg v 12 by C12 (Dex/Veh: 1763±176; Sal/Veh: 1581±158; Dex/C12: mmHg (5, 24) mmHg) or duodenal (70 mmHg (57, 101) mmHg v 85 1625±204; Sal/C12: 1119±210 (p<0.02 Sal/C12 vs. other condi- mmHg (46, 138)mmHg) motility between S and placebo groups. tions), indicating a CCK-1 receptor mediated effect. Finally the number of isolated pyloric pressure waves3 were not Conclusion: CCK-releasing fatty acids reduce tolerance to an affected by S (1st hour: 77 (40, 90) v 68 (50, 94), 2nd hour: 53 (18, intragastric liquid load in humans (a) by delaying gastric emptying 168) v 40 (27, 163), 3rd hour: 36 (8, 64) v 18 (3, 50)). and (b) via a CCK-1 receptor mediated effect. Conclusion: 5-HT1 receptor agonism with S suppresses antro- pyloro-duodenal motility immediately after meal ingestion, which may contribute to the increase in lag phase seen during gastric emptying. 004 GASTRIC MUCOSA IS INNERVATED BY HIGH GlaxoWellcome, UK, kindly supplied the sumatriptan for this study. THRESHOLD ACID SENSING NON-CAPSAICIN 1Alimen Pharmacol Ther 1992;6:685; 2Am J Physiol 1997;272: SENSITIVE SPINAL AFFERENTS G902; 3Gastroenterology 1988;94:276. J.I.W. Jones, D.A. Kendall1, P.J. Millns1, C.J. Hawkey. Division of Gastro- enterology, University Hospital, Nottingham NG7 2UH; 1Biomedical 006 A ROLE FOR 5-HYDROXYTRYPTAMINE (5-HT) IN THE Sciences, University of Nottingham, UK POSTPRANDIAL EXACERBATION OF SYMPTOMS IN FEMALE PATIENTS WITH DIARRHOEA PREDOMINANT IRRITABLE BOWEL SYNDROME (IBS) Introduction: Many patients suffer from acid sensitive dyspepsia yet the gastric mucosa is normally anaesthetic to luminal acid. We have L.A. Houghton1, W. Atkinson1, P. Whitaker2, P.J. Whorwell1,M.Rimmer3. previously reported that only a small proportion of mucosal spinal 1Dept of Medicine, University Hospital of South Manchester; 2Dept of afferents are sensitive to protons at pH 6.1 and hypothesised that this Chemical Pathology, University of Leicester; 3Glaxo Wellcome, Stockley was an adaptation to the presence of luminal acid. Park, UK Aims: To determine whether gastric mucosal nerves have a higher threshold for activation by acid than non-gastric nerves. Meal ingestion is often associated with an exacerbation of Methods: To study the effects of pH on the cell bodies of gastric gastrointestinal symptoms in patients with IBS.1 Furthermore, plasma mucosal nerves, we injected a neuronal tracer, Texas Red, into the 5-HT concentrations appear to increase more after a meal in patients gastric mucosa of 10 Wistar rats 2–4 weeks before removal of their with diarrhoea predominant IBS than healthy volunteers,2 suggesting dorsal root ganglia (DRG).