Caecal pH is a biomarker of excessive colonic fermentation - PubMed (original) (raw)

Caecal pH is a biomarker of excessive colonic fermentation

Adam D Farmer et al. World J Gastroenterol. 2014.

Abstract

Aim: To ascertain whether caecal pH is different in patients with irritable bowel syndrome (IBS), whose primary symptoms are bloating and distension, to healthy controls.

Methods: Motility and pH data were reviewed from 16 patients with Rome III defined IBS and 16 healthy controls, who had undergone a wireless motility capsule (WMC) study using a standardized protocol. Motility measures were anchored around known anatomical landmarks as identified by compartmental pH changes. Sixty-minute epochs were used to quantify antral, duodenal, ileal, caecal and distal colonic contractility. The maximum and minimum pH was measured either side of the ileo-caecal junction.

Results: No differences were seen in motility parameters, compartmental transit times or maximal ileal pH between the two groups. Caecal pH was significantly lower in patients compared to controls (5.12 ± 0.05 vs 6.16 ± 0.15, P < 0.0001). The ileal:caecal Δchange was greater in patients than controls (-2.63 ± 0.08 vs -1.42 ± 0.11, P < 0.0001). There was a significant correlation between caecal pH and right colonic contractility (r = 0.54, P = 0.002).

Conclusion: Patients with bloating and distension have a lower caecal pH compared to controls. The measurement of caecal pH using the WMC provides a quantifiable biomarker of fermentation potentially identifying those patients that may preferentially benefit from antibiotic or dietary interventions.

Keywords: Bloating; Caecal pH; Caecoparesis; Colonic microbiota; Fermentation.

PubMed Disclaimer

Figures

Figure 1

Figure 1

A typical wireless motility capsule trace demonstrating temperature (blue line), pH (green line) and contractility (red line) across the ileo-caecal junction. The pH drop was defined as the difference between the stable ileal pH and the caecal pH nadir. ICJ: Ileo-caecal junction.

Figure 2

Figure 2

Differences (mean ± SD) in ileal, caecal and ileo-caecal junction pH drop between patients and controls. Caecal pH significantly lower in patients than in controls and pH drop across the ICJ was lower in patients than in controls. b_P_ < 0.01 vs patients group. ICJ: Ileo-caecal junction.

Figure 3

Figure 3

Caecal pH and caecal contractility was positively correlated (r = 0.54, P = 0.002). AUC: Area under the curve.

References

    1. Jiang X, Locke GR, Choung RS, Zinsmeister AR, Schleck CD, Talley NJ. Prevalence and risk factors for abdominal bloating and visible distention: a population-based study. Gut. 2008;57:756–763. - PMC - PubMed
    1. Agrawal A, Houghton LA, Lea R, Morris J, Reilly B, Whorwell PJ. Bloating and distention in irritable bowel syndrome: the role of visceral nsation. Gastroenterology. 2008;134:1882–1889. - PubMed
    1. Jiang X, Locke GR, Zinsmeister AR, Schleck CD, Talley NJ. Health care seeking for abdominal bloating and visible distention. Aliment Pharmacol Ther. 2009;30:775–783. - PMC - PubMed
    1. Tuteja AK, Talley NJ, Joos SK, Tolman KG, Hickam DH. Abdominal bloating in employed adults: prevalence, risk factors, and association with other bowel disorders. Am J Gastroenterol. 2008;103:1241–1248. - PubMed
    1. Maxton DG, Morris JA, Whorwell PJ. Ranking of symptoms by patients with the irritable bowel syndrome. BMJ. 1989;299:1138. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources