Permeability oftherectosigmoid mucosatotritiated waterinnormal subjects andinpatients with mildidiopathic ulcerative colitis1

EDITORIALCOMMENT Absorption ofwaterfromthecolonic mucosa isimpaired inpatients with proctocolitis evenwhenthis disease ismild. Itiswell knownthat oneseverely disabling manifestation ofulcerative colitis isdiarrhoea, andamongthe mechanisms suggested toaccount foritinthis condition hasbeena derangement ofabsorption across thecolonic mucosa. Previous studies utilizing other substances than water havefailed todemonstrate deranged absorption fromtheinflamed rectosigmoid ofpatients with idiopathic ulcerative colitis (Levitan, Bikerman, Burrows, andIngelfinger, 1963). Theonlyquantitativeinformation concerning absorption ofwater fromthediseased coloninulcerative colitis was obtained fromstudies onanaesthetized patients with advanced disease who wereabouttoundergo colectomy (Duthie, Watts, deDombal, andGoligher, 1964). Inaddition, these patients weretreated with adrenal hormones. Itwasfelt, therefore, thatit wouldbeofinterest toobtain information about the transfer ofwateracross theinflamed rectosigmoid mucosainpatients whohaduntreated mildulcerativecolitis inremission andwerenotunderthe influence ofanaesthetics. Theaimofthepresent study wastomeasure the permeability oftherectosigmoid mucosatotritiated waterinnormal volunteers andinpatients withuntreated ulcerative colitis. Theappearance ofthe tritiated waterinvenousbloodfollowing rectal instillation wasusedasameasure ofcolonic permeability. No attempt wasmadetomeasure netwater absorption. Thisrelatively simple technique was utilized inthehopethat useful information could be obtained without physiological disturbance andwithoutsubjecting thepatients tolong, tedious intubation procedures.