ROLE OF IMPAIRED BILE ACID ABSORPTION IN POST-INFECTIVE GUT DYSFUNCTION

Infection with Trichinella spiralis induces acute inflammation that resolves as the worms leave the gut, 1–2 weeks post infection. Although the inflammation subsides, persistent abnormalities remain which have been used as a model of post-infectious irritable bowel syndrome (PI-IBS). The current study showed that 18 days post infection there was a striking increase in ileal secretion, both basal and bile acid-stimulated. This was associated with a marked reduction in bile acid absorption but paradoxically an increase in expression of the apical sodium dependant bile acid transporter (ASBT). While bile acid malabsorption (BAM) had resolved 1 week later, ileal water absorption remained depressed. The bowel distal to the ileum, which BAM would cause to be exposed to increased bile acids, continued to show increased basal secretion at 25 days, though the response to bile acids appeared depressed, possibly a compensatory mechanism. The authors speculate that increased delivery of bile acids to the colon may contribute to colonic hypermotility and secretion, and hence some of the symptoms of PI-IBS.

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IMPROVING POLYP DETECTION BY NARROW-BAND IMAGING: A LEARNING EFFECT?

Much …