Sugar reaching the colon because of intestinal maldigestion or malabsorption may be fermented to acetate and other short-chain fatty acids, resulting in stimulation of colonic water absorption and cell proliferation. To explore this phenomenon in more detail, we have developed a stable isotope model for estimating the fraction of colon-derived glucose or lactose that is fermented to acetate, propionate and butyrate. In an initial application of the model, [d3]-acetate and either [1-(13)C]-glucose or [D-1-(13)C]-lactose were infused into the cecum or colon of piglets, and plateau plasma acetate enrichment was monitored in the carotid artery. In acutely anesthetized piglets, the fractions of glucose and lactose fermented to acetate were 17.0 and 20.0%, respectively. In a chronically catheterized piglet, fermentation was higher (34.2%). When conducted in chronically catheterized animals or via a colostomy or ileostomy in infants, this model may be used to determine how age, previous surgery or antibiotic therapy affects the efficiency of colonic assimilation of carbohydrate.
We have developed a system for chronically catheterizing 10- to 25-d-old pigs that permits stable isotope tracer studies of intestinal or colonic assimilation of nutrients. This model also can be used to ensure constant enteral feeding or to assess the rate of entry into the terminal ileum of carbohydrates, fats, and amino acids. A plastic cannula with a luminal flange can be surgically placed in the stomach for tracer studies of sugar digestion or for controlled infusion of any formula diet. A similar cannula can be placed in the cecum for infusion of tracer and(or) substrates for studies of fermentation. The cannula has been machined so that a washer and nut can be threaded onto it, allowing the entire apparatus to be fixed to the abdominal wall. The distal end protruding above the skin was tapered to fit standard i.v. extension tubing. A carotid arterial catheter was used to sample substrates for isotopic enrichment measurements.
Piglets in three age groups (1-3, 9-11, and 16-25 days after birth) were used for in vivo colonic perfusions. Studies compared an isosmolar (312 mosM) with a high osmolar (551 mosM) solution and two equimolar substrates (with hexose concentrations of 73.1 mM), lactose and glucose-galactose. From the isosmolar perfusates, lactose absorption was 0.43 +/- 0.04 in the 18-20 day olds and 1.04 +/- 0.2 mumol.cm-1.min-1 in the 1-3 day olds; absorption from the glucose-galactose solution was negligible in all age groups (less than 0.05 +/- 0.05 mumol.cm-1.min-1). From the high osmolar perfusate, lactose absorption also exceeded that of glucose and galactose. In a third set of perfusion studies, the concentration of lactose was varied between 15 and 240 mM perfusate. Five-day-old animals absorbed 67% more lactose than 18-day-old animals; the right colon absorbed 57% more than the left. Lactose absorption, correlated with its concentration in the perfusate (r = 0.99), was nonsaturable at concentrations up to 240 mM, and was correlated with the uptake both of sodium (r2 = 0.59 for young and 0.64 for older neonates) and of chloride (r2 = 0.55 for young and 0.31 for older neonates). The results suggest that lactose may be removed from the colon without apparent cleavage by beta-galactosidase.
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