Enhanced Intestinal Absorption After Small Bowel Resection in Man

Weinstein, Louis; Shoemaker, Charles P.; Hersh, Theodore; Wright, Hastings K.

doi:10.1001/archsurg.1969.01340170012003

Cited by 118 publications

(45 citation statements)

References 7 publications

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“…The terminal ileum has the specific functions of absorbing vitamin B 12 [11,12] and bile salts. Any ileum remaining, after a small bowel resection, can structurally and functionally adapt so increasing absorption [13][14][15][16] , while remaining jejunum can only functionally adapt if some ileum or colon also remains [16][17][18][19] . Thus the outcome is more favourable after a jejunal than an ileal resection.…”

Section: Ileum or Jejunummentioning

confidence: 99%

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Management of patients with a short bowel

Nightingale

1999

Nutrition

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Section: Ileum or Jejunummentioning

confidence: 99%

“…In patients with a jejuno-colic anastomosis, no structural adaptation has been demonstrated [17,63,64] even though high GLP-2 levels are observed [65] . Functional adaptation with slowing of gastric emptying and small bowel transit may occur [31] and may be due to high circulating peptide YY levels [40] .…”

Section: Jejunum-colonmentioning

confidence: 99%

Management of patients with a short bowel

Nightingale

1999

Nutrition

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“…surface area reduces the absorption sites of almost all nutrients and, as a consequence, functional adaptation is seen involving the absorption of most nutrients (21,33). There is increased segmental absorption of fluid and electrolytes (36). Oligosaccr ... rides and monosaccharides are absorbed at increasing rates when absorption is expressed per length of intestine (21,31,37).…”

Section: Intestinal Adaptationmentioning

confidence: 99%

Short Bowel Syndrome: Intestinal Adaptation and Medical Therapy

Buie¹,

Og²,

Fedorak³

1990

Canadian Journal of Gastroenterology

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Short bowel syndrome is a clinical entity, a consequence of significant loss of intestinal surface area, and manifests a variable picture of diarrhea, steatorrhea, malabsorprion and weight loss. Previously high mortality rates have been reduced by the early use of parenteral nutrition and have subsequently resulted in increased survival and prevalence of the condition. Ultimate patient survival is dependent on the intrinsic adaptive ability of residual intestine and this, in tum, is dependent upon length, type, functional state and the presence or absence of an ileocecal valve. The mechanisms of intestinal adaptation are not entirely understood; however, they can be grouped into three broad categories: luminal nutrition, hormonal factors, and pancreaticobiliary secretion. Medical treatment of short bowel syndrome remains supportive and centres around the control of th ree pathophysiological defects: decreased intestinal transit time, gastric hypersecretion, and reduced functional mucosa! surface area.

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“…[10][11][12][13] Functional changes result in increased nutrient uptake by enterocytes. 11,14,15 There is an increase in absorption per unit length of carbohydrate, proteins, water, and electrolytes, 12,16,17 and upregulation of the sodiumglucose cotransporter enhancing fluid and electrolyte absorption. after resection.…”

Section: Introductionmentioning

confidence: 99%

New growth factor therapies aimed at improving intestinal adaptation in short bowel syndrome

Pereira¹,

Bines²

2006

J of Gastro and Hepatol

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Short bowel syndrome (SBS) is used to describe a condition of malabsorption and malnutrition resulting from the loss of absorptive area following massive small bowel resection. The key to improved clinical outcome after massive small bowel resection is the ability of the residual bowel to adapt. Although still in experimental stages, a major goal in the management of SBS may be the augmented use of growth factors to promote increased adaptation. A number of growth factors have been implicated in promoting the adaptation process. The best-described growth factors are reviewed: glucagon-like peptide-2 (GLP-2), epidermal growth factor (EGF), and growth hormone (GH). This article reviews the ability of recombinant GLP-2, EGF and GH to modulate structural and functional aspects of intestinal adaptation following small bowel resection. Although these growth factors have shown promise, small sample size, inconsistent measurement parameters and uncontrolled study designs have hampered the acquisition of strong data advocating the use of growth factor treatment for SBS. Multicenter trials using well-defined outcome measures to assess clinical efficacy are needed to direct the clinical indications, timing and duration of therapy and assess potential risks associated with growth factor therapies.

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Enhanced Intestinal Absorption After Small Bowel Resection in Man

Cited by 118 publications

References 7 publications

Management of patients with a short bowel

Management of patients with a short bowel

Short Bowel Syndrome: Intestinal Adaptation and Medical Therapy

New growth factor therapies aimed at improving intestinal adaptation in short bowel syndrome

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