Assessment of Jejunal Function in Patients with Dermatitis Herpetiformis and Adult Coeliac Disease Using a Perfusion Technique

Abstract

Kumar, P. J., Silk, D. B. A., Rousseau, B., Pagaltsos, A. S., Clark, M. L., Dawson, A, M. & Marks, R. Assessment of jejunal function in patients with dermatitis herpetiformis and adult coeliac disease using a perfusion technique. Scand. J. Gastroent. 1974, 9, 793–798.

The jejunum of 12 patients with untreated adult coeliac disease (ACD) and 23 patients with dermatitis herpetiformis (DH) with varying morphological abnormalities of the small bowel was perfused with a double lumen tube incorporating a proximal occlusive balloon. Water absorption from a 56 mM solution of glucose was significantly depressed in 7 of 9 patients with ACD and 6 of 10 with DH with subtotal villous atrophy (SVA). actual secretion being seen in 4 patients in each group. Glucose absorption from this solution was depressed in 5 of 9 with ACD and 4 of 10 with DH and SVA. Abnormalities of absorption were also seen in DH patients with partial villous atrophy (PVA) and normal jejunal biopsies. Using a 35 mM saline-bicarbonate solution, bicarbonate absorption was depressed in 2 of 8 with ACD. 2 of 11 with DH and SVA, 1 of 5 with PVA, and 2 of 5 with normal biopsies. Changes in water absorption from this solution were less affected, being depressed in only 5 of 8 with ACD and one each with DH and SVA and a normal biopsy. These results indicate that, using this technique, more abnormalities of jejunal function are demonstrated than would be expected from routine gastrointestinal function tests.

Key-words::

• Adult coeliac disease
• bicarbonate
• dermatitis herpetiformis
• glucose
• human perfusion
• jejunal function