Humors and Diarrhea

To the Editor: Luderer et al. state, in their article entitled “Elevated Prostaglandin E in Idiopathic Pseudo-obstruction” (N Engl J Med 295:1179, 1976), “Prostaglandins have been implicated in the pathogenesis of…diarrhea syndromes, including cholera….” They provide no documentation for this statement. Early in this decade prostaglandins were shown to increase mucosal adenyl cyclase in the intestine¹ and to stimulate small-bowel water and electrolyte secretion.² When it was shown that cholera enterotoxin also stimulates adenyl cyclase, thereby increasing the concentration of cyclic AMP and stimulating small-bowel water and electrolyte secretion,¹³ it was suggested that the effects of the toxin might.