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. 2006 Dec 21;12(47):7635-41.
doi: 10.3748/wjg.v12.i47.7635.

Sorbitol-based osmotic diarrhea: possible causes and mechanism of prevention investigated in rats

Md Shahidul Islam  1 , Ei Sakaguchi
Affiliations

Sorbitol-based osmotic diarrhea: possible causes and mechanism of prevention investigated in rats

Md Shahidul Islam et al. World J Gastroenterol. .

Abstract

Aim: To study the possible causes of sorbitol (S)-based diarrhea and its mechanism of reduction by rice gruel (RG) in cecectomized rats.

Methods: S was dissolved either in distilled water or in RG (50 g/L) and ingested as a single oral dose (1.2 g/kg body mass, containing 0.5 g/L phenol red as a recovery marker) by S (control) and S + RG groups (n = 7), respectively. This dose is over the laxative dose for humans. Animals were sacrificed exactly 1 h after dose ingestion, without any access to drinking water. The whole gastro-intestinal tract was divided into seven segments and sampled to analyze the S and marker remaining in its contents.

Results: Gastric-emptying and intestinal transit were comparatively slower in the S + RG group. Also, the S absorption index in the 3(rd) and last quarter of the small intestine (24.85 +/- 18.88% vs 0.0 +/- 0.0% and 39.09 +/- 32.75% vs 0.0 +/- 0.0%, respectively, P < 0.05) was significantly higher in the S + RG group than in the control group. The S absorption index and the intestinal fluid volume are inversely related to each other.

Conclusion: The intestinal mal-absorption of S is the main reason for S-based osmotic diarrhea. Where RG enhanced the absorption of S through passive diffusion, the degree of diarrhea was reduced in cecectomized rats.

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Figures

Figure 1
Figure 1
Distribution of marker (phenol red) in the different segments of the gastrointestinal tract 1 h after the dose ingestion. aP = 0.035, cP = 0.045 vs S group.
Figure 2
Figure 2
Gastric emptying 1 h after the dose ingestion.
Figure 3
Figure 3
Sorbitol absorption index in the different segments of the intestinal tract during the 1 h period after dose ingestion. aP = 0.016, cP = 0.023 vs S group.
Figure 4
Figure 4
Relationship between the intestinal fluid volume and sorbitol absorption index of S and S + RG ingestion groups. One gram of intestinal contents was considered as 1 mL for the calculation of the volume of intestinal fluid. aP < 0.05 vs S group.
Figure 5
Figure 5
Correlation between the sorbitol absorption index (Y axis) and intestinal fluid volume (X axis) of S (□) and S + RG (■) groups in the different segments of the small intestine (SI), colon, and whole intestine. The P values indicate significant differences in the 1st quarter (P = 0.0064), 2nd quarter (P = 0.056), last quarter (P = 0.0085) of the small intestine; proximal colon of large intestine (P = 0.0259); and for the whole intestine (P < 0.0001) when S and S + RG groups are compared.
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