The Thyroid and the Gut

  title={The Thyroid and the Gut},
  author={Ellen C. Ebert},
  journal={Journal of Clinical Gastroenterology},
  • E. Ebert
  • Published 1 July 2010
  • Medicine
  • Journal of Clinical Gastroenterology
Thyroid disease is common, and its effects on the gastrointestinal system are protean, affecting most hollow organs. Hashimoto disease, the most common cause of hypothyroidism, may be associated with an esophageal motility disorder presenting as dysphagia or heartburn. Dyspepsia, nausea, or vomiting may be due to delayed gastric emptying. Abdominal discomfort, flatulence, and bloating occur in those with bacterial overgrowth and improve with antibiotics. Reduced acid production may be due to… 

Gastrointestinal and Hepatic Manifestations of Systemic Diseases

Gastrointestinal (GI) presentations are common manifestations of systemic disease and range from hypomotility in hypothyroidism to hypermotility in hyperthyroidism, and associated autoimmune gastritis.

Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review.

Gastroparesis in Older Adults

Etiological factors for delayed gastric emptying include effects of diseases and drugs; common causes include diabetes mellitus, Parkinson’s disease, hypothyroidism, chronic renal failure, and gastric cancer.

Thyrotoxic Vomiting: A Case Report and Possible Mechanisms

Clinicians should consider the possibility of thyrotoxicosis in patient with unexplained and repeated vomiting who was initially presented with repeated vomiting and epigastric pain who improved remarkably after treatment with antithyroid drugs.

Hashimoto’s thyroiditis in patients with normal thyroid-stimulating hormone levels

Further research is warranted to clarify the main pathophysiologic implications of thyroid autoimmunity and also to establish treatment options for euthyroid patients who suffer from HT-related symptoms and diseases.

Systemic Disease Affecting the Stomach

This chapter reviews systemic conditions that cause macroscopic and microscopic mucosal changes such as gastritis, which may be clinically and histologically distinct from primary inflammation. A


It is observed that esophageal motility can be affected via shortened duration of contraction in Graves' disease and the gastrointestinal symptoms due to possible motility dysfunctions should be considered in the evaluation of hyperthyroid patients.

Hypothyroidism as a cause of ileus after laparoscopic appendectomy

Hypothyroidism should be considered in patients with protracted postoperative ileus after abdominal surgery, and the patient was discharged with restored bowel function and much improved clinical condition with follow-up with endocrinology.



Gastrointestinal transit in thyroid disease.

Gastrointestinal transit time in fasting patients with thyroid dysfunction is studied using the pulmonary excretion of H2 after the ingestion of a nonabsorbable carbohydrate, lactulose, as an indicator of the rate of transit to the colon to support the hypothesis that abnormal gut motility may be the primary cause of the diarrhea and malabsorption of hyperthyroidism.

Association between hypothyroidism and small intestinal bacterial overgrowth.

The history of overt hypothyroidism is associated with bacterial overgrowth development and excess bacteria could influence clinical gastrointestinal manifestations, however, fermenting carbohydrate luminal bacteria do not interfere with thyroid hormone levels.

The effect of hyperthyroidism on gastric emptying rates and pancreatic exocrine and biliary secretion in man

It is concluded that in hyperthyroidism gastric emptying rates of “physiologically active” food is normal and Pancreatic enzyme secretion is depressed in hyper thyroidism and may contribute to maldigestion.

Gastric, pancreatic, and biliary responses to meals in hyperthyroidism.

Abnormalities responsible for the diarrhoea and steatorrhoea in hyperthyroidism appear to reside primarily distal to the duodenum, and reduced bile acid output may be a contributory factor in some patients.

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.

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.

Gastro-intestinal polypeptides in patients treated for medullary carcinoma of the thyroid.

It is concluded that gastro-intestinal polypeptides, which are produced by other apudomas, are not secreted in more than normal concentrations under basal conditions, by the majority of patients previously treated for medullary carcinoma of the thyroid.

Antigastric Antibodies in Hyperthyroidism: Their Relationship to Impaired Acid Secretion

Tests for antigastric antibody have now been performed on a group of patients with hyperthyroidism by means of the immuno fluorescent technique, which demonstrates the reaction of this antibody with a paniculate component of parietal-cell cyto plasm and is the most sensitive method at present available for its detection.

The relation between gastrin, gastric acid and thyroid function disorders.

It is concluded that thyrotoxic hypergastrinaemia cannot be fully explained by the low gastric acid output in hyperthyroidism.

Effect of hyperthyroidism on the transit of a caloric solid-liquid meal through the stomach, the small intestine, and the colon in man.

It is concluded that in thyrotoxicosis small and large intestinal transit is accelerated, while gastric emptying remains unchanged and rapid intestine transit is likely to be one factor among others implicated in the generation of diarrhea.