Distal small bowel motility and lipid absorption in patients following abdominal aortic aneurysm repair surgery

Abstract

Both proximal and distal small intestinal motor activity are transiently disrupted in critically ill patients immediately after major surgery, with abnormal motility patterns extending as far as the ileum. These motor disturbances may contribute to impaired absorption of enteral nutrition, especially when intraluminal processing is necessary for efficient digestion.

Managing Diarrhea During Enteral Feeding in ICU

“…A normal polymeric feeding formula should be the standard choice as there is little evidence of improved tolerance with alternative types of feed in most patients (Borlase et al 1992;Heimburger et al 1995). A review of the choice of feeding formula is indicated if diarrhea persists, to rule out causes such as hyperosmolar formula (Smith et al 1990) or malabsorption (Fraser et al 2006).…”

Relationship between altered small intestinal motility and absorption after abdominal aortic aneurysm repair

“…Small intestinal lipid and glucose absorption were assessed by 13 C-triolein breath test [12,21] and 3-O-methylglucose (3-OMG) concentrations [12,21], respectively. The test meal was 60 ml Ensure Ò (21% fat, 20% protein, 59% carbohydrate with 1 kcal/ml; Abbott Australia, Kurnell, Australia) mixed with 200 ll [1,1,1-13 C3] triolein (99%, 200 mg; Cambridge Isotope Laboratories, USA) and 3 g 3-OMG (98%; Sigma-Aldrich, St Louis, MO, USA) [12,21].…”

“…The test meal was 60 ml Ensure Ò (21% fat, 20% protein, 59% carbohydrate with 1 kcal/ml; Abbott Australia, Kurnell, Australia) mixed with 200 ll [1,1,1-13 C3] triolein (99%, 200 mg; Cambridge Isotope Laboratories, USA) and 3 g 3-OMG (98%; Sigma-Aldrich, St Louis, MO, USA) [12,21].…”

“…While enteral feeding is the preferred route for nutrient delivery, impaired gut motility and absorption hinder adequate nutrition [16][17][18]. Persistence of phase III-like burst activity during feeding occurs in both proximal and distal SI segments in patients undergoing repair of abdominal aortic aneurysm (AAA) and critical illness [19][20][21]. Earlier data suggested that disruption in postprandial motility is associated with reduced lipid absorption [21].…”

“…Persistence of phase III-like burst activity during feeding occurs in both proximal and distal SI segments in patients undergoing repair of abdominal aortic aneurysm (AAA) and critical illness [19][20][21]. Earlier data suggested that disruption in postprandial motility is associated with reduced lipid absorption [21]. To date, the relationships between SI pressure wave activity, transit and absorption in these patients have not been evaluated.…”