SUMMARY The possibility that malabsorbed fat passing through the human ileum exerts an inhibitory feedback control on jejunal motility has been investigated in 24 normal subjects by perfusing the ileum with a fat containing solution designed to produce ileal luminal fat concentrations similar to those in steatorrhoea (30-40 mg/ml). Mean transit times through a 30 cm saline perfused jejunal segment were measured by a dye dilution technique. Thirty minutes after ileal fat perfusion, mean transit times rose markedly to 18 9±2 5 minutes from a control value of 7*5±0-9 minutes (n=5; p<005). This was associated with an increase in volume of the perfused segment which rose to 17541±229 ml (control 976±103 ml, n=5; p<005). Transit times and segmental volumes had returned towards basal values 90 minutes after completing the fat perfusion. Further studies showed that ileal fat perfusion produced a pronounced inhibition of jejunal pressure wave activity, percentage duration of activity falling from a control level of 40 3±5 0% to 14 9±2 8% in the hour after ileal perfusion (p<001). Ileal fat perfusion was associated with marked rises in plasma enteroglucagon and neurotensin, the peak values (218±37 and 68±13 1 pmol/l) being comparable with those observed postprandially in coeliac disease. These observations show the existence in man of an inhibitory intestinal control mechanism, whereby ileal fat perfusion inhibits jejunal motility and delays caudal transit of jejunal contents.
Direct measurement of N tau-methylhistidine turnover in skeletal muscle, skin and gastrointestinal muscle indicates that these three tissues contribute only 24.9, 6.8 and 9.8% of the total urinary excretion. Measurement of the decay rate of radioactively labelled N tau-methylhistidine in urine indicates that skeletal muscle accounts for 74.5% of the urinary excretion and this is probably an overestimate. These results suggest that the common assumption, that N tau-methylhistidine in urine originates almost entirely from skeletal muscle, may be wrong.
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