N]ureide is a tool with good properties to investigate the effect of different types of carbohydrates on nitrogen metabolism in the proximal colon in vivo. carbohydrate fermentation; stable isotopes THE ACCUMULATION OF AMMONIA in the colon is of great importance for human health. First, part of the ammonia formed in the colon is salvaged for human metabolism. On a normal protein diet, it has been estimated that every day ϳ30% of the nitrogen present in urea produced in the liver is salvaged from the colon and 70% of the salvaged nitrogen is utilized for amino acid and protein synthesis (7). Second, the amount of ammonia produced in the colon is important in some pathological conditions, such as chronic portosystemic encephalopathy and end-stage renal failure (3, 26). Third, some of the effects of ammonia described in in vitro studies may point to a possible local toxic effect on the colonic mucosa. Ammonia has been shown to affect the intermediary metabolism and DNA synthesis in colonic epithelial cells and to reduce their life span. It increases the turnover of epithelial cells, and in this way, increases the probability of genetic damage occurring in the presence of oncogenic agents because dividing cell populations are more susceptible to chemical carcinogenesis (22).Ammonia is derived from proteolysis and ureolysis in the lumen of the large intestine. On average, 0.3-4.1 g of nitrogen, the majority in the form of protein and peptides, enter the colon daily from the small bowel (11). The polypeptide chains in dietary and endogenous protein are hydrolyzed by proteases and peptidases to amino acids, which are further metabolized through various reactions involving deamination with the production of ammonia. Ammonia can also be derived from urea. There are two possible ways in which urea may reach the microflora of the large bowel: through the ileocecal valve or by diffusion of blood urea in intestinal contents. The flux of urea from the ileum to the colon is estimated to be only 0.75 g/day (5). The flux of urea by diffusion from the blood through the colonic wall depends on protein intake, metabolic state of the host, and energy supply to the colonic flora. Intraluminal hydrolysis of urea into ammonia is so fast that very little intact urea molecules may be detected in the colonic lumen.The accumulation of ammonia in the large bowel can be decreased by reducing the dietary protein intake, but also by administration of fermentable carbohydrates. In vitro experiments have shown that carbohydrate fermentation affects bacterial protein metabolism in different ways. Carbohydrate fermentation results in a decrease of the pH through production of short-chain fatty acids. As a consequence, protease activity will decrease because large intestinal proteases have a neutral to alkaline pH optimum (11,19). In addition, amino acid metabolism is decreased when fermentable carbohydrates are present in the medium (18,19,21,23). This effect is suggested to be caused by catabolite repression, which implies that in the presence of...