Document Detail

Net digestive absorption and adaptive hyperphagia in adult short bowel patients.
MedLine Citation:
PMID:  15306586     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Intestinal adaptation after small bowel resection in humans is debated. We have quantified in adult short bowel (remnant small bowel length <2 m) patients oral intake and net digestive absorption and their evolution over time.
PATIENTS AND METHODS: Oral intake and faecal output were studied over three days in 90 patients (39 and 51 without or with parenteral nutrition, respectively) and in 14 patients in early (<6 months) and late (>6 months) periods after digestive continuity. Nitrogen and fat output were measured using chemiluminescence and Van de Kamer techniques, respectively.
RESULTS: In the whole group, 81% of patients had hyperphagia (spontaneous oral intake >1.5 x resting energy expenditure), independently and negatively related to fat absorption (p<0.01) and body mass index (p<0.001) but not braked by the presence of parenteral nutrition. Protein and fat absorption were related to small bowel length. We observed, in the late in comparison with the early period after digestive continuity: an increase in oral intake (1.6 v 2.3 resting energy expenditure), decrease in stool weight/oral intake ratio, no reduction in per cent fat absorption, and protein absorption improvement associated with a significant increase in the amount of protein absorbed (40 v 64 g/day; p<0.05), both being correlated with remnant small bowel length (p<0.01).
CONCLUSIONS: This study confirms an adaptive hyperphagia in adult short bowel patients. Over time, hyperphagia and amount of protein absorbed increased, the latter being related to remnant small bowel length, indicating a behavioural adaptation that allows expression of intestinal absorptive adaptation.
P Crenn; M C Morin; F Joly; S Penven; F Thuillier; B Messing
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Gut     Volume:  53     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-12     Completed Date:  2004-10-04     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  England    
Other Details:
Languages:  eng     Pagination:  1279-86     Citation Subset:  AIM; IM    
Hepatogastroenterology and Nutrition Support Department, Hôpital Lariboisière, 2 rue Ambroise Paré, 75475 Paris Cedex 10, France.
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MeSH Terms
Adaptation, Physiological
Aged, 80 and over
Body Mass Index
Dietary Proteins / pharmacokinetics
Energy Intake
Hyperphagia / physiopathology*
Intestinal Absorption*
Middle Aged
Parenteral Nutrition
Short Bowel Syndrome / pathology,  physiopathology*,  therapy
Reg. No./Substance:
0/Dietary Proteins

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