Background-Coarse bran is known to accelerate transit through the whole gut and to increase stool weight. This effect is much reduced by grinding the bran, suggesting that particle size influences gut motor patterns.Aims-To compare the effect of 15 g coarse bran with 15 g inert plastic particles and 7 g of ispaghula on The viscous gelling agent ispaghula also increases stool weight7 8 but in humans at least it does not always shorten transit,8 perhaps because of the increased viscosity of small bowel contents. This enhanced ability of coarse bran to accelerate transit compared with fibre sources, which increase stool bulk equally, is as yet unexplained. One possibility is that the unfermentable particles of bran stimulate intestinal nerve endings resulting in either mucosal secretion or a more propulsive motor pattern. Recent studies9 have suggested that 15 g inert plastic particles can increase stool water and accelerate transit as much as 37 g of coarse bran but have not shown from which region of the gut this effect originates. The small bowel, which is well innervated and is known to respond to mechanical stimulation by secreting fluid,'0 seemed to us to be the most likely site of action. Faster transit here, by reducing nutrient and water absorption, would increase ileocolonic inflow and hence accelerate colonic transit.The present study therefore aimed to examine the effect of coarse bran on small bowel transit and to compare this with inert plastic particles. We also examined the effect of a contrasting viscous, but non-particulate, pure fibre source ispaghula which, in dogs at least," increases small bowel water content but does not alter small bowel transit.
MethodsThirteen healthy volunteers, eight men and five women, mean age 60 (range 50-72) years, free from gastrointestinal symptoms and taking no regular medication, took part in this four way, randomised, crossover study. Subjects attended after an overnight fast on four occasions and ate a rice pudding test meal with or without either bran, fybogel, or inert plastic particles. Subjects were asked to eat all the meal within five minutes. Gastric emptying, small bowel transit, and colonic filling were measured by -y-scintigraphy on each occasion.
Bran is an effective treatment for constipation but its use is often limited by heartburn and bloating. This study examined the effect of fine and coarse bran (15 g) on the gastric emptying and small bowel transit of a 325 kcal rice test meal. Twelve healthy volunteers underwent a three way cross over study, ingesting the technetium-99m labelled rice meal with or without 15 g of indium-l1lm labelled fine or coarse bran, in random order. Serial scintigraphic images were obtained to define gastric emptying and colonic arrival of label. Compared with control values (99 (9) minutes) (mean (SEM)), the time to 50% gastric emptying was significantly delayed by coarse but not fine bran, being 121 (6) and 104 (9) minutes respectively, p<0 05, n=12. Fundal emptying was unchanged but both brans seemed to increase the proportion of isotope in the antrum at 90 minutes. Small bowel transit was slightly faster with both bran types but in this study the difference was not significant. Both the bran and rice labels moved down the gut without significant separation. Fine bran causes less disturbance of gastric physiology than coarse bran.
BACKGROUND: Endovascular repair (EVR) of abdominal aortic aneurysm (AAA) is feasible for selected patients. Placing an uncovered stent across the origins of the renal arteries may improve fixation and seal of the proximal end of the stent-graft. However, this has potential for problems (e.g. renal artery stenosis or microembolization). This study aimed to evaluate the short-term effect of a suprarenal stent on the function of the individual kidney. METHODS: In 30 patients undergoing EVR for AAA, renal function was assessed before and after operation by 99mTc-radiolabelled diethylenetriamine penta-acetate radionuclide renography and daily measurement of serum creatinine levels. Eleven patients had infrarenal stent-grafts using an aorta uni-iliac system (group 1); 19 patients had the device with an uncovered suprarenal stent (modified Gianturco Z stent), ten of which were aorta uni-iliac and nine bifurcated systems (group 2). Individual kidney function was expressed as the whole kidney transit time (WKTT). In addition, glomerular filtration rate (GFR) was measured from serial blood samples following renography. RESULTS: [Table: see text] CONCLUSION: No result reached statistical significance. Placing an uncovered stent over the origins of the renal arteries does not appear to impair kidney function in the short term.
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