Prolonged intestinal transit and diarrhea in patients with an activating GUCY2C mutation.

INTRODUCTION: Increased intestinal hydration by activation of the epithelial enzyme linked receptor guanylate cyclase C (GC-C) is a pharmacological principle for treating constipation. Activating mutations in the GUCY2C gene encoding GC-C cause Familial GUCY2C diarrhea syndrome (FGDS) which has been diagnosed with severe dysmotility. AIM: To investigate gut motility and hormones before and after a meal in FGDS patients and compare with healthy controls (HC). SUBJECTS AND METHODS: Bristol stool chart and stool frequency was assessed. Before and after a meal occlusive and non-occlusive contractions were obtained using ultrasound. A wireless motility capsule (WMC) recorded gut transit time, pH, contractions and pressure. Plasma levels of selected gut hormones were measured at different time points. RESULTS: The FGDS patients had 4 (range 1-10) loose stools/day and prolonged total gut transit time compared to HC, 55.5 h vs 28.5 h, respectively,with significantly increased colon transit time. In FGDS patients, pH in duodenum, small bowel and colon was increased and the number of contractions and the intraluminal pressure were significantly decreased, measured by WMC. Ultrasound showed in small bowel increased number of non-occlusive contractions in the FGDS patients. Serotonin (5-HT) plasma levels in the HC peaked 30 min after the meal, while the FGDS patients had no response. CONCLUSION: Despite having diarrhea, the FGDS patients have prolonged transit time through the gut compared to HC, particularly in colon. The reduced number of intestinal contractions and lack of 5-HT release after a meal in FGDS patients surprisingly resemble colonic motility disturbances seen in patients with constipation.

The effect of stunning methods and season on muscle texture hardness in Atlantic salmon (Salmo salar L.).

UNLABELLED: Commercially collected records of Atlantic salmon (Salmo salar L.) muscle texture hardness were used to evaluate the effect of slaughter procedures and seasonality on texture quality. A database collected by Marine Harvest® contained flesh hardness records of Atlantic salmon slaughtered at processing plants in Norway from summer 2010 to summer 2011. The fish were slaughtered either by (1) percussion followed by automated bleeding ("Percussive") or (2) live chilling with exposure to carbon dioxide (CO2 ) followed by manual severing gill arches and bleeding ("CO2 ") or (3) live chilling with exposure to CO2 followed by percussive stunning and at the end automated bleeding ("CO2 ·percussive"). Hardness in salmon muscle cutlets was measured in Newtons (N) by Materials Testing Machine Zwick 500N. The hardness in salmon varied significantly over the study period (P < 0.05, mixed effect model) and showed the softest value of 21.2 (± 0.7) Newton (N) in summer 2011 and hardest 24.1 (± 0.2) N in autumn 2010. Slaughter procedures had a significant effect on salmon muscle hardness (P < 0.05, mixed effect model), where percussion followed by automated bleeding resulted in the hardest value (24.0 ± 0.4 N) as compared with CO2 stunning (21.8 ± 0.2 N) and combination of CO2 and percussive stunning (23.1 ± 0.15 N). CO2 is suspected as a causal factor in accelerated postmortem softening of the salmon muscle. PRACTICAL APPLICATION: Commercial use of CO2 in combination with live chilling results in accelerated postmortem softening of the muscle tissue in salmon and should be avoided.