The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection

Jeppesen, Palle Bekker; Mortensen, Per Brøbech

doi:10.1136/gut.43.4.478

Cited by 185 publications

(98 citation statements)

References 24 publications

(14 reference statements)

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“…21,22 Diet and fecal nitrogen in grams were converted to diet and fecal grams of protein by multiplying by 6.25. The energy conversion factors were those of Atwater et al, as confirmed by Southgate and Durnin 23 : 17.6, 23.6, and 39.1 kJ/g for carbo-hydrate, protein, and fat, respectively.…”

Section: Balance Studiesmentioning

confidence: 99%

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon

et al. 2001

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Background & Aims: Glucagon-like peptide 2 (GLP-2) is intestinotrophic, antisecretory, and transit-modulating in rodents, and it is mainly secreted from the intestinal mucosa of the terminal ileum and colon after food ingestion. We assessed the effect of GLP-2 on the gastrointestinal function in patients without a terminal ileum and colon who have functional short-bowel syndrome with severe malabsorption of wet weight (>1.5 kg/day) and energy (>2.3 MJ/day) and no postprandial secretion of GLP-2. Methods: Balance studies were performed before and after treatment with GLP-2, 400 g subcutaneously twice a day for 35 days, in 8 patients (4 -17 years from last bowel resection; 6 with Crohn's disease). Four patients received home parenteral nutrition (mean residual jejunum, 83 cm), and 4 did not (mean ileum resection, 106 cm). Biopsy specimens were taken from jejunal/ileal stomas, transit was measured by scintigraphy, and body composition was measured by dual-energy x-ray absorptiometry. Results: Treatment with GLP-2 improved the intestinal absorption of energy 3.5% ؎ 4.0% (mean ؎ SD) from 49.9% to 53.4% (P ‫؍‬ 0.04), wet weight 11% ؎ 12% from 25% to 36% (P ‫؍‬ 0.04), and nitrogen 4.7% ؎ 5.4% from 47.4% to 52.1% (P ‫؍‬ 0.04). Body weight increased 1.2 ؎ 1.0 kg (P ‫؍‬ 0.01), lean body mass increased 2.9 ؎ 1.9 kg (P ‫؍‬ 0.004), fat mass decreased 1.8 ؎ 1.3 kg (P ‫؍‬ 0.007), and 24-hour urine creatinine excretion increased (P ‫؍‬ 0.02). The time to 50% gastric emptying of solids increased 30 ؎ 16 minutes from 89 to 119 minutes (P < 0.05). Small bowel transit time was not changed. Crypt depth and villus height were increased in 5 and 6 patients, respectively. Conclusions: Treatment with GLP-2 improves intestinal absorption and nutritional status in short-bowel patients with impaired postprandial GLP-2 secretion in whom the terminal ileum and the colon have been resected.

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Section: Balance Studiesmentioning

confidence: 99%

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon

et al. 2001

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“…A peptide diet has a relatively high osmolality and thus can increase stomal output [151] . Little advantage comes from taking a diet of watersoluble medium chain triglycerides in place of normal fat [148] . The addition of glutamine (15 gm) to a litre of rehydration solution in patients with jejunostomy resulted in no additional benefit in terms of water or sodium absorption [152] .…”

Section: Undernutrition -Protein-energy Malnutritionmentioning

confidence: 99%

“…If a diet is high in monosaccharides D (-) lactic acidosis may occur (see below). Medium chain triglycerides are an alternative source of energy and are absorbed from the small and large bowel [145][146][147][148] . In order to increase the energy absorption, reduce the risk of renal stones and D (-) lactic acidosis, patients with a retained colon need a large totalenergy intake with a diet high in carbohydrate (polysaccharides) [29] , but not increased in fat (long chain triglycerides) and low in oxalate.…”

Section: Undernutrition -Protein-energy Malnutritionmentioning

confidence: 99%

“…Conservation of the colon is advantageous as it absorbs water, sodium [21][22][23][24][25] , magnesium [25,26] , calcium [27] , short and medium chain fatty acids [28][29][30] , slows gastro-intestinal transit [31] and stimulates small intestinal hyperplasia [32] . Patients with a preserved colon after a small bowel resection may survive without parenteral support with a very short [33,34] or even no remaining jejunum [35] .…”

Section: Colonmentioning

confidence: 99%

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Management of patients with a short bowel

Nightingale

1999

Nutrition

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“…The human colon has not often been considered to be a site of fat absorption; however, the small intestine absorbs only approximately 95% of dietary lipids after consumption of a typical Western diet. 149 Furthermore, some studies have suggested that colonic absorption of medium-chain fatty acids takes place in dogs, 150 rats, 151 and humans 152,153 and that glycerol accumulates in the colon when fat absorption is disturbed in the small intestine. 154 Accumulation of glycerol has been shown to alter the Lactobacillus and Enterococcus communities in the gut.…”

Section: Microbiota Interactionsmentioning

confidence: 99%

Emerging Aspects of Food and Nutrition on Gut Microbiota

He¹,

Marco²,

Slupsky³

2013

J. Agric. Food Chem.

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The human gastrointestinal tract contains a highly complex ecosystem that harbors various microorganisms, which together create a unique environment within each individual. There is growing awareness that dietary habits are one of the essential factors contributing to the microbial diversity and community configuration that ultimately affects human health. From an evolutionary perspective, human dietary history can be viewed as a central factor in the selection of the gut microbial community and stabilization of the mutualistic host−microbial interaction, that together drive host phenotype. Herein, current knowledge concerning the influence of major dietary macrostructure and individual food ingredients is presented. This knowledge will provide perspectives for personalized gut microbiota management and, ultimately, movement toward an era of personalized nutrition and medicine. KEYWORDS: gut microbiome, diet, nutrition, food, colon, dietary fiber ■ INTRODUCTIONWe live in an intimate relationship with microorganisms that are present on the surfaces and cavities of the human body. During birth, or shortly thereafter, microbes from the mother's skin and milk, the air, and inanimate objects enter the virtually germ-free system of the neonate and proliferate to a dramatic extent. The gastrointestinal (GI) tract is the most densely populated microbial ecosystem of the mammalian host. Bacterial cells are most abundant, but other types of microbes are also present in the GI tract, such as archaea, viruses, protozoa, and fungi. The intestinal lumen alone harbors 10 times more bacterial cells than eukaryotic cells in the entire human body, an amount equivalent to approximately 1 kg of human mass.1 This fact leads us to view ourselves as "superorganisms", being composed of our cells as well as microbial cells that are dependent on each another for survival. 2Food is a major source of energy that promotes growth and development, immunity, and tissue repair, as well as homeostatic regulation. It is also an important energy source for gut microbiota.3,4 Although most nutrient absorption occurs in the small intestine, the colon harbors the majority of bacterial colonists. The colon can be viewed as the major site for "co-metabolic" activity, which enhances the efficiency of the energy harvest from foods 5,6 and influences the synthesis, bioavailability, and function of nutrients, 4 vitamins, 7,8 and drugs.9,10 Thus, the functional interaction between microbes and their host explains individual variability of nutrient metabolism and bioavailability.11 Understanding the relationship between the gut microbiome and diet is important for the development of next-generation therapeutic foods that target these microbes in health-promoting ways and will ultimately usher us toward an era of personalized nutrition and medicine.In this paper, current knowledge of the gut microbiome from the perspective of human dietary history and the coevolutionary relationship with the host will be broadly reviewed. The impact of major dietary...

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The influence of a preserved colon on the absorption of medium chain fat in patients with small bowel resection

Cited by 185 publications

References 24 publications

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon

Glucagon-like peptide 2 improves nutrient absorption and nutritional status in short-bowel patients with no colon

Management of patients with a short bowel

Emerging Aspects of Food and Nutrition on Gut Microbiota

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