Mechanisms of Diarrhea

Diarrhea is a symptom common to a wide variety of gastrointestinal illnesses, and is an important public health challenge in underdeveloped regions of the world. Normal intestinal absorption is a complex process. Recent research offers new insights into normal physiology and pathophysiology. The rol...

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Bibliographic Details
Published in:Current gastroenterology reports 2010-08, Vol.12 (4), p.236-241
Main Author: Surawicz, Christina M.
Format: Article
Language:English
Subjects:
Adenosine
Bile Acids and Salts - metabolism
Blood vessels
Chloride
Colon
Diarrhea
Diarrhea - complications
Diarrhea - etiology
Diarrhea - metabolism
Diarrhea - physiopathology
Electrolytes
Enteric Nervous System - metabolism
Fatty acids
Gastroenterology
Humans
Inflammatory bowel disease
Inflammatory Bowel Diseases - metabolism
Intestinal Absorption - physiology
Irritable bowel syndrome
Irritable Bowel Syndrome - metabolism
Medicine
Medicine & Public Health
Motility
Muscle contraction
Nervous system
Neuropeptides
Nutrients
Pathogens
Pathophysiology
Peptides
Phosphoproteins
Serotonin
Small intestine
Smooth muscle
Sodium
Sodium-Hydrogen Exchangers - metabolism
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Summary:Diarrhea is a symptom common to a wide variety of gastrointestinal illnesses, and is an important public health challenge in underdeveloped regions of the world. Normal intestinal absorption is a complex process. Recent research offers new insights into normal physiology and pathophysiology. The role of the enteric nervous system and neurotransmitters in the pathogenesis of diarrhea in inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) is being actively investigated. In patients with IBD, ileal and sigmoid biopsies showed altered transepithelial sodium and fluid transport, specifically from decreased expression of the NHE3, NHERF-1, and NHE1 epithelial Na channel. This results in changes in normal intestinal electroneutral NaCl absorption and may be an additional factor contributing to the diarrhea in patients with IBD. Physiologic studies in humans suggest that primary bile acid malabsorption may be caused by an abnormal feedback system resulting in the increased bile salts, which may explain the watery diarrhea. Finally, the role of zinc in treatment of infectious diarrhea led to studies of its effect on intracellular human enterocyte ion secretion. Understanding such basic mechanisms may lead to better and novel therapies for treatment of diarrhea.
ISSN:1522-8037
1534-312X
DOI:10.1007/s11894-010-0113-4