# Abnormal Plasma Intestinal Peptide Levels Found In IBS Investigation



## Mike NoLomotil (Jun 6, 2000)

The confirmatory findings of this new report in the January 2001 issue of GUT of exaggerated perceptual levels in IBS patients are not surprising and not new BUT...the altered serum levels of certain GI peptides in response to a "postprandial stimulating event" is.Of particular interest, the abnormal levels of (2) GI peptides (Motilin and CRF)compared to the controls, with differentiation between C types and D types via serum Corticotrophin Releasing Factor is found. This is very very interesting as Motilin (secreted by endocrinocytes in the mucosa of the proximal small intestine) participates in controlling the pattern of smooth muscle contractions in the stomach and small intestine, and bursts of Motilin secretion are what stimulate the "migrating motor complex" (the disseminated motor activity that occurs during the interdigestive state betweens meals...creates that sensation of activity throughout the gut...the contractions-gurgling-rumbling etc....its a "housekeeping function" that is often reported to be exaggerated by IBS patients).And CRF, produced in the hypothalamus, has been associated with....anxiety and depression. Seems the D types had more than the C types. D types more depressed and anxious innately? While the samples are small, it certainly supports the belief that further investigation into this area is warranted. These finidngs are also consistent with some of the other as yet unpublished developmental and investigatory observations of others....(nice to see someone else starting to snoop around in the plasma of IBS patients, too).MNL_______________ www.leapallergy.com ________________________________________________________________________________Gut 2001 Jan;48(1):20-27An Exaggerated Sensory Component of the Gastrocolonic Response In Patients With Irritable Bowel Syndrome.Simren M, Abrahamsson H, Bjornsson ESDepartment of Internal Medicine, Sahlgrenska University Hospital, Goteborg, Sweden.BACKGROUND/AIMS: Visceral hypersensitivity is a feature of the irritable bowel syndrome (IBS). Postprandial symptoms are common in these patients. The effects of nutrients on colonic perception in IBS are incompletely understood. SUBJECTS: We studied 13 healthy subjects and 16 patients with IBS-eight had diarrhoea predominant (IBS-D) and eight constipation predominant (IBS-C) IBS. METHODS: Colonic perception thresholds to balloon distension and viscerosomatic referral pattern were assessed before and after duodenal infusion of lipid or saline, respectively. At the end of the infusions, plasma levels of gastrointestinal peptides were determined. RESULTS: Lipids lowered the thresholds for first sensation, gas, discomfort, and pain in the IBS group but only for gas in the control group. The percent reduction in thresholds for gas and pain after lipids was greater in the IBS and IBS-D groups but not in the IBS-C group compared with controls. IBS patients had an increased area of referred discomfort and pain after lipids compared with before infusion whereas the referral area remained unchanged in controls. No group differences in colonic tone or compliance were observed. In both groups higher levels of cholecystokinin, pancreatic polypeptide, peptide YY, vasoactive intestinal polypeptide, and neuropeptide Y were seen after lipids. Motilin levels were higher in patients, and differences in the subgroups were observed. Levels of Corticotrophin Releasing Factor were lower in the constipated group than in the diarrhoea group. CONCLUSIONS: Postprandial symptoms in IBS patients may be explained in part by a nutrient dependent exaggerated sensory component of the gastrocolonic response.PMID: 11115818


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