Liver cirrhosis is related to increased prevalence of gastrointestinal symptoms, insulin resistance, and modified gut transit. The goal of the current study is to evaluate the prevalence of gut transit defects in patients with cirrhosis, and contrasted it with healthy controls. In addition, the authors also assessed the association of gut transit with gastrointestinal symptoms and postprandial glucose and hormone profiles.

The study included 42 consecutive patients with cirrhosis and investigated half-gastric emptying, small bowel residence, and colonic filling times with a validated radiologic procedure. Among these, in a subgroup of 25 patients, gastrointestinal symptoms were appraised by using a validated questionnaire and a caloric satiation test. Additionally, the study evaluated postprandial glucose, insulin, leptin, ghrelin, glucagon-like peptide 1, and PYY responses. These recruited patients were contrasted with 83 healthy subjects, which were included as controls for the transit studies, and 10 for the hormone analyses.

The outcome of the study showed that among patients with cirrhosis, 24% had delayed gastric emptying and 38% had prolonged small bowel transit in comparison to controls. Delayed gastric emptying was associated with postprandial fullness and prolonged small bowel transit to diarrhea and abdominal pain. These patients also had raised postprandial glucose, insulin, and glucagon-like peptide 1 responses and decreased postprandial ghrelin. In addition, delayed gastric emptying was associated with elevated postprandial glucose and decreased postprandial ghrelin. Prolonged small bowel transit was reported to be correlated with increased postprandial glucose and insulin and reduced postprandial ghrelin.

Based on these findings, it can be concluded that majority patients with cirrhosis show delayed gastric emptying or small bowel transit, suggestive of an association with gastrointestinal symptoms. Thus, a correlation exists between postprandial hyperglycemia, hyperinsulinemia, and hypoghrelinemia, and delayed gut transit in patients with cirrhosis.

Source: Kalaitzakis E, Sadik R, Holst JJ, Ohman L, Björnsson E. Gut transit is associated with gastrointestinal symptoms and gut hormone profile in patients with cirrhosis. Clin Gastroenterol Hepatol. 2009 Mar;7(3):346-52.