Liver cirrhosis is associated with increased prevalence of gastrointestinal symptoms,
insulin resistance, and altered gut transit. We aimed to assess the prevalence of
gut transit abnormalities in patients with cirrhosis, compared with healthy controls,
and to evaluate the relation of gut transit with gastrointestinal symptoms and postprandial
glucose and hormone profiles.
Half gastric emptying, small bowel residence, and colonic filling times were measured
with a validated radiologic procedure in 42 consecutive patients with cirrhosis. In
a subgroup of 25 patients, gastrointestinal symptoms were evaluated by using a validated
questionnaire and a caloric satiation test. Postprandial glucose, insulin, leptin,
ghrelin, glucagon-like peptide 1, and PYY responses were also studied. Eighty-three
healthy subjects served as controls for the transit studies and 10 for the hormone
analyses.
Of patients with cirrhosis, 24% had delayed gastric emptying and 38% had prolonged
small bowel transit (P < .05 compared with controls). Delayed gastric emptying was
related to postprandial fullness and prolonged small bowel transit to diarrhea and
abdominal pain (P < .05 for all). The patients with cirrhosis had increased postprandial
glucose, insulin, and glucagon-like peptide 1 responses and reduced postprandial ghrelin.
Delayed gastric emptying was related to increased postprandial glucose and reduced
postprandial ghrelin. Prolonged small bowel transit was related to increased postprandial
glucose and insulin and reduced postprandial ghrelin.
A high proportion of patients with cirrhosis exhibit delayed gastric emptying or small
bowel transit, which is related to gastrointestinal symptoms. Postprandial hyperglycemia,
hyperinsulinemia, and hypoghrelinemia might be linked to delayed gut transit in cirrhosis.