Abstract
Hyperbilirubinemic newborns (h.n.) in phototherapy (ph) often develop diarrhea. We have previously presented evidence that this is of secretory type (1), furthermore in an animal model we showed that bilirubin acts as a secretagogue in the proximal jejunum (2) and this can be held responsible for such effect. In order to investigate the involvement of the colon in such secretory state, we studied electrolyte and water transport, using the technique of non equilibrium dialysis of the rectum with an isotonic solution, in 10 h.n. in ph, in 10 h.n. not light treated and in 10 controls. All infants were at term and breast fed. There were no differences in birthweight, gestational age, weight and age at beginning of the study between the three groups. Bilirubin level at the study was 15±0.3 mg% in the light treated group and 13.9±0.2 mg% in the group of h.n. not in ph. Results, expressed as water and electrolyte net fluxes, are reported in the table.
CONCLUSIONS: the impaired absorption of water and electrolytes seen in h.n. in ph. and not in the h.n. not light treated demonstrates: 1) the colonic involvement in the pathogenesis of secretory diarrhea and 2) that this effect is caused by the simultaneous action of hyperbilirubinemia and phototherapy.
1)M.De Curtis et al.Lancet 1,909,1982; 2)A.Fasano et al.Pediatr.Res.18,1049,1984.
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De Curtis, M., Guandalini, S., Saitta, F. et al. 66 INVOLVEMENT OF THE COLON IN THE PATHOGENESIS OF DIARRHEA IN JAUNDICED INFANTS IN PHOTOTHERAPY. Pediatr Res 24, 416 (1988). https://doi.org/10.1203/00006450-198809000-00089
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DOI: https://doi.org/10.1203/00006450-198809000-00089