Proceedings: Abnormalities of cholecystokinin secretion and gallbladder emptying in coeliac disease.
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Biomedical subjects
Publications and source records attributed to R F Harvey.
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Four patients are described who were surreptitiously taking thyroxine-containing tablets. In two cases this caused considerable diagnostic problems. The diagnosis should be considered in patients with clinical features of hyperthyroidism (but without goitres or proptosis), who appear psychiatrically abnormal and whose thyroid function tests show conflicting results.
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Magnesium sulphate, a substance known to cause release of cholecystokinin (CCK) from the small intestinal mucosa, was given by mouth (dose 0.1g/kg in 150 ml water) to 20 patients with the irritable bowel syndrome. A rapid increase in colonic segmental motor activity (onset within two to six minutes in most cases) was seen (percentage activity increased from 16.2 to 23.7 p<0.05; mean wave amplitude from 7.1 to 9.1 cm H(2)O, NS; motility index from 144 to 259, p<0.01). This increase was most marked in 10 patients who complained of attacks of abdominal pain after food (16.1 to 29.8%, p<0.01; 6.8 to 9.6 cm H(2)O, p<0.05; 135 to 350, p<0.05), and after the magnesium sulphate three of these patients experienced an attack of their usual pain. These findings provide further evidence that ;functional' abdominal pain after food may in some cases be related to an exaggerated intestinal motor response to cholecystokinin.
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A prospective study of bowel frequency in patients with thyroid disease showed increased frequency of bowel action in thyrotoxicosis and decreased frequency in myxoedema. The contrary findings of previous studies may be due to the use of inexact criteria in interrogation of the patients.
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