{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:01:01Z","timestamp":1783486861026,"version":"3.55.0"},"reference-count":34,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1988,4]]},"abstract":"<jats:p>Intubation techniques and scintigraphic studies were used to determine the origin and mechanism of diarrhoea in a patient with medullary thyroid carcinoma, high plasma immunoreactive calcitonin and normal circulating serotonin, substance P and prostaglandins E2 and F2 alpha. Normal function of the small intestine was found for the following: (a) absorption tests; (b) water and electrolyte absorption in the proximal jejunum; (c) 24 hour flow rate and composition of fluid entering the colon and (d) gastric emptying rate and small intestinal progression of a normal meal. By contrast, colonic function was markedly impaired in three ways: (a) water absorption was decreased by half; (b) as the main excreted solutes were organic acids, a large electrolyte gap was recorded in faecal water, and (c) colonic transit time of the meal marker was very short, and was in agreement with the rapid transit of ingested radioopaque markers. These data strongly suggest that decreased absorption in the colon secondary to a motor disturbance is the main mechanism of diarrhoea in this case of medullary thyroid carcinoma, while calcitonin induced small intestinal fluid secretion suggested earlier is either non-existent, or only of minor importance.<\/jats:p>","DOI":"10.1136\/gut.29.4.537","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"537-543","source":"Crossref","is-referenced-by-count":29,"title":["Pathophysiological study of diarrhoea in a patient with medullary thyroid carcinoma. Evidence against a secretory mechanism and for the role of shortened colonic transit time."],"prefix":"10.1136","volume":"29","author":[{"given":"J C","family":"Rambaud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Jian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Flouri\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Hautefeuille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Salmeron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Thuillier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Ruskon\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Florent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Chaoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J J","family":"Bernier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1988,4,1]]},"reference":[{"key":"ref_1","first-page":"602","volume-title":"Diarrhoea and thyroid carcinoma. Proc R Soc Med 1966","volume":"59","author":"Williams, E.D.","unstructured":"Williams ED. Diarrhoea and thyroid carcinoma. Proc R Soc Med 1966; 59: 602-3."},{"key":"ref_2","first-page":"899","article-title":"Manifestations intestinales des affections thyroidiennes. Aspects cliniques et physiopathologiques actuels","volume":"4","author":"Marechaud, R.; Rambaud, J.C.; Matuchansky, C.","year":"1980","unstructured":"Marechaud R, Rambaud JC, Matuchansky C. Manifestations intestinales des affections thyroidiennes. Aspects cliniques et physiopathologiques actuels. Gastroenterol Clin Biol 1980; 4: 899-910.","journal-title":"Gastroenterol Clin Biol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1002\/1097-0142(197305)31:5<1237::AID-CNCR2820310530>3.0.CO;2-K","article-title":"Diarrhea and medullary carcinoma of the thyroid","volume":"31","author":"Steinfeld, C.M.; Moertel, C.G.; Wollner, L.B.","year":"1973","unstructured":"Steinfeld CM, Moertel CG, Wollner LB. Diarrhea and medullary carcinoma of the thyroid. Cancer 1973; 31: 1237-9.","journal-title":"Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/00005792-198411000-00001","article-title":"Medullary carcinoma of the thyroid","volume":"63","author":"Saad, M.F.; Ordonez, N.G.; Rasmid, R.K.","year":"1984","unstructured":"Saad MF, Ordonez NG, Rasmid RK, et al. Medullary carcinoma of the thyroid. Medicine 1984; 63: 319-42.","journal-title":"Medicine"},{"issue":"10","key":"ref_5","first-page":"980","article-title":"Diarrhoea associated with medullary carcinoma of the thyroid","volume":"1969","author":"Bernier, J.J.; Rambaud, J.C.; Cattan, D.; Prost, A.","unstructured":"Bernier JJ, Rambaud JC, Cattan D, Prost A. Diarrhoea associated with medullary carcinoma of the thyroid. Gut 1969; 10: 980-5.","journal-title":"Gut"},{"key":"ref_6","first-page":"392","article-title":"Ion transport changes during calcitonin-induced intestinal","volume-title":"secretion in man. Gastroenterology 1976; 71","author":"Gray, T.K.; Brannan, P.; Juan, D.; Morawski, S.G.; Fordtran, J.S.","unstructured":"Gray TK, Brannan P, Juan D, Morawski SG, Fordtran JS. Ion transport changes during calcitonin-induced intestinal secretion in man. Gastroenterology 1976; 71: 392-8."},{"key":"ref_7","first-page":"257","article-title":"disease. Pathophysiology. Diagnosis. Management","author":"Krejs, G.J.; Diarrhea, Fordtran J.S.","year":"1983","unstructured":"Krejs GJ, Fordtran JS. Diarrhea. In: Sleisenger MH, Fordtran JS, eds. Gastrointestinal disease. Pathophysiology. Diagnosis. Management. Philadelphia: Saunders, 1983: 257-80."},{"key":"ref_8","first-page":"777","article-title":"Medullary carcinoma and other disorders involving calcitonin","volume":"2","author":"Williams, E.D.","year":"1979","unstructured":"Williams ED. Medullary carcinoma and other disorders involving calcitonin. In: DeGroot LJ, eds. Endocrinology. Vol 2. New York: Grune and Stratton, 1979: 777-92."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1677\/joe.0.0330469","article-title":"A biological assay for calcitonin","volume":"33","author":"Kumar, M.A.; Slack, E.; Edwards, A.","year":"1965","unstructured":"Kumar MA, Slack E, Edwards A, et al. A biological assay for calcitonin. J Endocrinol 1965; 33: 469-75.","journal-title":"J Endocrinol"},{"key":"ref_10","first-page":"9","article-title":"1ttude de l'absorption intestinale du sodium et du potassium par la perfusion intestinale de solutes isotoniques chez l'homme","volume":"36","author":"Rambaud, J.C.; Ch, Thiry; Bernier, J.J.","year":"1973","unstructured":"Rambaud JC, Thiry Ch, Bernier JJ. 1ttude de l'absorption intestinale du sodium et du potassium par la perfusion intestinale de solutes isotoniques chez l'homme. Acta Gastro-enterol Belg 1973; 36: 9-29.","journal-title":"Acta Gastro-enterol Belg"},{"key":"ref_11","first-page":"165","article-title":"Effets du glucose sur les mouvements nets et unidirectionnels de l'eau et des electrolytes dans l'intestin grele de l'homme","volume":"5","author":"Modigliani, R.; Bernier, J.J.","year":"1972","unstructured":"Modigliani R, Bernier JJ. Effets du glucose sur les mouvements nets et unidirectionnels de l'eau et des electrolytes dans l'intestin grele de l'homme. Biol Gastroenterol 1972; 5: 165-74.","journal-title":"Biol Gastroenterol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/BF01295657","article-title":"Effect of somatostatin on diarrhea and on small intestinal water and electrolyte transport in a patient with pancreatic cholera","volume":"27","author":"Ruskone, A.; Rend, E.; Chayvialle, J.A.","year":"1982","unstructured":"Ruskone A, Rend E, Chayvialle JA, et al. Effect of somatostatin on diarrhea and on small intestinal water and electrolyte transport in a patient with pancreatic cholera. Dig Dis Sci 1982; 27: 459-66.","journal-title":"Dig Dis Sci"},{"key":"ref_13","first-page":"139","article-title":"Ittude sur 24 heures des flux liquidiens intestinaux chez l'homme normal par la technique de la perfusion lente d'un marqueur non absorbable","volume":"3","author":"Emonts, P.; Vidon, N.; Bernier, J.J.; Rambaud, J.C.","year":"1979","unstructured":"Emonts P, Vidon N, Bernier JJ, Rambaud JC. Ittude sur 24 heures des flux liquidiens intestinaux chez l'homme normal par la technique de la perfusion lente d'un marqueur non absorbable. Gastroenterol Clin Biol 1979; 3:139-46.","journal-title":"Gastroenterol Clin Biol"},{"key":"ref_14","first-page":"686","article-title":"The contribution of the colon to electrolyte and water conservation in man","volume":"70","author":"Phillips, S.F.; Giller, J.","year":"1967","unstructured":"Phillips SF, Giller J. The contribution of the colon to electrolyte and water conservation in man. J Lab Clin Med 1967; 70: 686-98.","journal-title":"J Lab Clin Med"},{"key":"ref_15","first-page":"223","article-title":"Contribution a l'etude des dlectrolytes des selles","volume":"69","author":"Goiffon, R.; Goiffon, B.; Fron, G.","year":"1961","unstructured":"Goiffon R, Goiffon B, Fron G. Contribution a l'etude des dlectrolytes des selles. II. Mesure des cations Na, K, Ca, Mg, NH3. Gastroenterologia 1961; 69:223-34."},{"issue":"69","key":"ref_16","first-page":"312","article-title":"Contribtion a l'etude des electrolytes des selles. II. Mesure des anions","volume":"1961","author":"Goiffon, R.; Goiffon, B.; Fron, G.","unstructured":"Goiffon R, Goiffon B, Fron G. Contribtion a l'etude des electrolytes des selles. II. Mesure des anions. Gastroenterologia 1961; 69: 312-25.","journal-title":"Gastroenterologia"},{"key":"ref_17","first-page":"219","article-title":"Transit through the gut measured by analysis of a single stool","volume-title":"Gut","volume":"17","author":"Cummings, J.H.; Wiggins, H.S.","year":"1976","unstructured":"Cummings JH, Wiggins HS. Transit through the gut measured by analysis of a single stool. Gut 1976; 17: 219-23."},{"key":"ref_18","first-page":"755","article-title":"Ittude de la progression d'un repas dans l'intestin grele de l'homme par une methode isotopique","volume":"3","author":"Jian, R.; Pecking, A.; Najean, Y.; Bernier, J.J.","year":"1979","unstructured":"Jian R, Pecking A, Najean Y, Bernier JJ. Ittude de la progression d'un repas dans l'intestin grele de l'homme par une methode isotopique. Gastroenterol Clin Biol 1979; 3: 755-62.","journal-title":"Gastroenterol Clin Biol"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/S0016-5085(19)32854-9","article-title":"Diarrhea associated with medullary carcinoma of the thyroid","volume":"67","author":"Isaacs, P.; Whitaker, S.M.; Turnberg, L.A.","year":"1974","unstructured":"Isaacs P, Whitaker SM, Turnberg LA. Diarrhea associated with medullary carcinoma of the thyroid. Gastroenterology 1974; 67: 521-6.","journal-title":"Gastroenterology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/gut.20.7.629","article-title":"Role of calcitonin in diarrhoea associated with medullary carcinoma of the thyroid","volume":"20","author":"Cox, T.M.; Fagan, E.A.; Hillyard, C.J.; Allison, D.J.; Chadwick, V.S.","year":"1979","unstructured":"Cox TM, Fagan EA, Hillyard CJ, Allison DJ, Chadwick VS. Role of calcitonin in diarrhoea associated with medullary carcinoma of the thyroid. Gut 1979; 20: 629-33.","journal-title":"Gut"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/0016-5085(78)90246-9","article-title":"Capacity of the human colon to absorb fluids","volume":"74","author":"Debongnie, J.D.; Phillips, S.F.","year":"1978","unstructured":"Debongnie JD, Phillips SF. Capacity of the human colon to absorb fluids. Gastroenterology 1978; 74: 698-703.","journal-title":"Gastroenterology"},{"issue":"26","key":"ref_22","first-page":"929","article-title":"Maximal capacity for fluid absorption in human bowel","volume":"1981","author":"Palma, R.; Vidon, N.; Bernier, J.J.","unstructured":"Palma R, Vidon N, Bernier JJ. Maximal capacity for fluid absorption in human bowel. Dig Dis Sci 1981: 26: 929-34.","journal-title":"Dig Dis Sci"},{"issue":"4","key":"ref_23","first-page":"553","article-title":"Intestinal ganglioneuromatosis, Pathophysiological study ofdiarrhoea in a patient with medullary thyroid carcinoma 543 diarrhoea and medullary thyroid carcinoma","volume":"1969","author":"Norman, T.; Otnes, B.","unstructured":"Norman T, Otnes B. Intestinal ganglioneuromatosis, Pathophysiological study ofdiarrhoea in a patient with medullary thyroid carcinoma 543 diarrhoea and medullary thyroid carcinoma. Scand J Gastroenterol 1969; 4: 553-9.","journal-title":"Scand J Gastroenterol"},{"key":"ref_24","first-page":"141","article-title":"Diagnostic and pathophysiologic studies in patients with chronic diarrhea","author":"Krejs, G.J.; Hendler, R.S.; Fordtran, J.S.","year":"1980","unstructured":"Krejs GJ, Hendler RS, Fordtran JS. Diagnostic and pathophysiologic studies in patients with chronic diarrhea. In: Fields M, Fordtran JS, Schultz SC, eds. Secretory diarrhea. Baltimore: American Physiological Society, Waverly Press Inc, 1980: 141-51."},{"issue":"37","key":"ref_25","first-page":"549","article-title":"In vivo dialysis of faeces as a method of stool analysis. IV. The organic anion component","volume":"1969","author":"Rubinstein, R.; Howard, A.V.; Wrong, O.M.","unstructured":"Rubinstein R, Howard AV, Wrong OM. In vivo dialysis of faeces as a method of stool analysis. IV. The organic anion component. Clin Sci 1969; 37: 549-64.","journal-title":"Clin Sci"},{"key":"ref_26","first-page":"1276","article-title":"Transit of a meal through the stomach, small intestine and colon in normal subjects and its role","volume-title":"the pathogenesis of diarrhea. Gastroenterology 1980","volume":"79","author":"Read, N.W.; Miles, C.A.; Fisher, D.","unstructured":"Read NW, Miles CA, Fisher D, et al. Transit of a meal through the stomach, small intestine and colon in normal subjects and its role in the pathogenesis of diarrhea. Gastroenterology 1980, 79: 1276-82."},{"key":"ref_27","first-page":"141","article-title":"Medullary (solid) carcinoma of the thyroid gland: an analysis of the M","volume":"52","author":"Hill, C.S.; Ibanez, M.L.; Naguib, A.S.; Ahearn, M.J.; Clark, R.L.","year":"1973","unstructured":"Hill CS, Ibanez ML, Naguib AS, Ahearn MJ, Clark RL. Medullary (solid) carcinoma of the thyroid gland: an analysis of the M.D. Anderson Hospital experience with patients with tumor, its special features, and its histogenesis. Medicine 1973; 52: 141-71.","journal-title":"its special features, and its histogenesis. Medicine"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1210\/jcem-57-4-749","article-title":"Identification and characterization of calcitonin forms in plasma and urine of normal subjects and medullary carcinoma patients","volume":"57","author":"Tobler, P.H.; Tschopp, F.A.; Cambacher, M.A.; Born, W.; Fischer, J.A.","year":"1983","unstructured":"Tobler PH, Tschopp FA, Cambacher MA, Born W, Fischer JA. Identification and characterization of calcitonin forms in plasma and urine of normal subjects and medullary carcinoma patients. J Clin Endocrinol Metab 1983; 57: 749-54.","journal-title":"J Clin Endocrinol Metab"},{"key":"ref_29","first-page":"269","volume":"304","author":"Austin, L.A.; Calcitonin, Heath H.","year":"1981","unstructured":"Austin LA, Heath H. Calcitonin. Physiology and pathophysiology. N Engl J Med 1981; 304: 269-78.","journal-title":"Physiology and pathophysiology. N Engl J Med"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0016-5085(74)80132-0","article-title":"Effect of calcitonin on meal-stimulated gastric acid secretion and serum gastrin concentration","volume":"66","author":"Bieberdorf, F.A.; Gray, K.; Walsh, J.H.; Fordtran, J.S.","year":"1974","unstructured":"Bieberdorf FA, Gray K, Walsh JH, Fordtran JS. Effect of calcitonin on meal-stimulated gastric acid secretion and serum gastrin concentration. Gastroenterology 1974; 66: 343-6.","journal-title":"Gastroenterology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/S0140-6736(68)90010-X","article-title":"Prostaglandin secretion by medullary carcinoma of the thyroid. A possible cause of the associated diarrhoea","volume":"i:","author":"Williams, E.D.; Karim, S.M.M.; Sandler, M.","year":"1968","unstructured":"Williams ED, Karim SMM, Sandler M. Prostaglandin secretion by medullary carcinoma of the thyroid. A possible cause of the associated diarrhoea. Lancet 1968; i:22-3.","journal-title":"Lancet"},{"key":"ref_32","first-page":"11","article-title":"Diarrhoea in thyroid medullary carcinoma: role of prostaglandins and therapeutic effect of nutmeg","volume":"iii:","author":"Barrowman, J.A.; Bennett, A.; Hillebrand, P.; Kolles, K.; Pollock, D.J.; Wright, J.T.","year":"1975","unstructured":"Barrowman JA, Bennett A, Hillebrand P, Kolles K, Pollock DJ, Wright JT. Diarrhoea in thyroid medullary carcinoma: role of prostaglandins and therapeutic effect of nutmeg. Br Med J 1975; iii: 11-2.","journal-title":"Br Med J"},{"key":"ref_33","first-page":"273","article-title":"Malignant carcinoid syndrome associated with noncarcinoid tumors","volume":"1965","author":"Moertel, C.G.; Beahr, O.H.; Woolner, L.B.; Tyce, G.M.","unstructured":"Moertel CG, Beahr OH, Woolner LB, Tyce GM. Malignant carcinoid syndrome associated with noncarcinoid tumors. N Engl J Med 1965: 273: 244-8.","journal-title":"N Engl J Med"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1007\/BF01963325","article-title":"Substance P in medullary carcinoma of the thyroid","volume":"35","author":"Skrabanek, P.; Cannon, D.; Dempsey, J.; Kirrane, J.; Neligan, M.; Powel, D.","year":"1979","unstructured":"Skrabanek P, Cannon D, Dempsey J, Kirrane J, Neligan M, Powel D. Substance P in medullary carcinoma of the thyroid. Experientia 1979 35: 1259-60.","journal-title":"Experientia"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.29.4.537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T16:38:03Z","timestamp":1765643883000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.29.4.537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1988,4]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1988,4,1]]},"published-print":{"date-parts":[[1988,4]]}},"alternative-id":["10.1136\/gut.29.4.537"],"URL":"https:\/\/doi.org\/10.1136\/gut.29.4.537","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1988,4]]}}}