Henry J. Binder, M.D.

Professor of Medicine
Professor of Cellular and Molecular Physiology
Section of Digestive Diseases and Cellular and Molecular Physiology
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Research Interests

The goal of our research program is to further the understanding of the regulation of colonic electrolyte transport; the clinical expression of these studies is an increased knowledge of the pathophysiology of and improved treatment for diarrheal disorders.

Over the past several years I have pursued studies of potassium transport in the large intestine as well as the role of different anion exchangers to regulate colonic HCO3 secretion. In addition, we have pursued extensive studies of the role of short-chain fatty acids (SCFA). SCFA are the primary anion in stool; are not in the diet but are synthesized (fermented) from non-absorbed carbohydrate by colonic bacteria. SCFA are avidly absorbed by the colon by a mechanism that required an apical membrane SCFA-HCO3 exchange; Na-H exchange; and Cl-SCFA exchange.

The unexpected failure of cyclic nucleotides to inhibit SCFA stimulation of Na-Cl absorption led to the hypothesis that the colon might be utilized as an adjunct to the small intestine to improve the effectiveness of oral rehydration solution (ORS). We proposed and have now established in studies in adults with cholera and children with non-cholera diarrhea that starch that is relatively resistant to pancreatic amylase digestion (and that we call resistant starch or RS) could serve to improve oral rehydration therapy (ORT) in the treatment of diarrhea. RS results in enhancing colonic SCFA production that in turn would result in increased fluid and Na absorption. These studies have been performed in collaboration with Prof B. S. Ramakrishna at Christian Medical College, Vellore, India. Further trials are in progress and planned to establish the optimal resistant starch formulation for ORT and optimal circumstances for its use. Laboratory studies have also been performed to establish why cAMP does not inhibit SCFA stimulation of colonic Na-Cl absorption.

Clinical Interests

General gastroenterology with particular interest in diarrheal and inflammatory bowel disease.

Selected Publications

• Ramakrishna, B.S., Venkataraman, S., Srinivasan, P., Dash, P., Young, G.P., and Binder, H.J. (2000) Amylase-resistant starch plus oral rehydration solution for cholera. New Engl. J. Med. 342: 308-313.
• Binder, H.J.: Disorders of absorption. In: Harrison’s Principles of Internal Medicine. Ed. Fauci, A. Kasper, D.L., McGraw Hill, New York. 17th ed. (in press).
• Sandeep S, Rajendran VM, Srinivasan P, Nanda Kumar NS, Ramakrishna BS, Binder HJ: Differential regulation of cholera toxin-inhibited Na-H exchange isoforms by butyrate in rat ileum. Am J Physiol Gastrointest Liver Physiol. 2007 Oct;293(4):G857-63.
• Binder HJ: Causes of chronic diarrhea. N Engl J Med. 2006 Jul 20;355(3):236-9.

Contact

Campus Address
Department of Internal Medicine
333 Cedar Street (LMP 89)
New Haven, CT 06520

E-mail
henry.binder@yale.edu

Office Phone
203-785-4796