Influence of diet complexity on intestinal adaptation following massive small bowel resection in a preclinical model

Bines, Julie E; Taylor, Russell G.; Justice, Frances; Paris, M.C.J.; Sourial, Magdy; Nagy, Éva; Emselle, Sarah; Catto‐Smith, Anthony G.; Fuller, Peter J.

doi:10.1046/j.1440-1746.2002.02872.x

Cited by 55 publications

(64 citation statements)

References 49 publications

(152 reference statements)

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“…24 Finally, complex nutrients stimulate a greater degree of intestinal adaptation than do more hydrolyzed nutrients. 25,26 The functional capacity of the gastrointestinal (GI) tract is reflected by this anatomic gradient. Digestion occurs primarily in the stomach and proximal small intestine.…”

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confidence: 99%

Pathophysiology of Short Bowel Syndrome

Tappenden

2014

J Parenter Enteral Nutr

161

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The human small intestine is organized with a proximal‐to‐distal gradient of mucosal structure and nutrient processing capacity. However, certain nutrients undergo site‐specific digestion and absorption, such as iron and folate in the duodenum/jejunum vs vitamin B12 and bile salts in the ileum. Intestinal resection can result in short bowel syndrome (SBS) due to reduction of total and/or site‐specific nutrient processing areas. Depending on the segment(s) of intestine resected, malabsorption can be nutrient specific (eg, vitamin B12 or fat) or sweeping, with deficiencies in energy, protein, and various micronutrients. Jejunal resections are generally better tolerated than ileal resections because of greater postresection adaptive capacity than that of the jejunum. Following intestinal resection, energy scavenging and fluid absorption become particularly important in the colon owing to loss of digestive and absorptive surface area in the resection portion. Resection‐induced alterations in enteroendocrine cell abundance can further disrupt intestinal function. For example, patients with end jejunostomy have depressed circulating peptide YY and glucagon‐like peptide 2 concentrations, which likely contribute to the rapid intestinal transit and blunted intestinal adaptation observed in this population. SBS‐associated pathophysiology often extends beyond the gastrointestinal tract, with hepatobiliary disease, metabolic bone disease, D‐lactic acidosis, and kidney stone formation being chronic complications. Clinical management of SBS must be individualized to account for the specific nutrient processing deficit within the remnant bowel and to mitigate potential complications, both inside and outside the gastrointestinal tract.

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confidence: 99%

Pathophysiology of Short Bowel Syndrome

Tappenden

2014

J Parenter Enteral Nutr

161

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“…The majority of studies used domestic pigs or piglets [5,13,16,17,18,19] mainly of female gender [10,13,16,18,20,21,22,23,24,25,26,27,28,29]. Regarding the exact breed, mostly landrace [10,21,22,30,31] or landrace × large white [5,13,16,20,24,26,32,33,34] animals were used.…”

Section: Resultsmentioning

confidence: 99%

“…If mentioned, most often anesthesia with halothane and oxygen [17,18,21,24,27] or isoflurane [19,37] was performed, sometimes in combination with ketamine and azaperone [7]. In rare occasions, other strategies such as anesthesia with propofol, fentanyl and pancuronium [5], thiopental sodium and ketamine [7], or a combination of the mentioned drugs [29,41] were chosen.…”

Section: Resultsmentioning

confidence: 99%

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Models of Short Bowel Syndrome in Pigs: A Technical Review

Weih

Nickkholgh²,

Keßler³

et al. 2013

Eur Surg Res

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Background: Short bowel syndrome (SBS) is still a life-threatening disease in both children and adults. Although the therapeutic options are improving, challenges still remain, and to overcome these challenges is a major focus of SBS research today. In order to simulate anatomical and physiological conditions similar to those in humans for research, porcine models of SBS are often used. Various approaches for generating SBS models have been described in the literature. Methods/Results: In this work, we present a review of different types of porcine models of SBS and outline the differences between those models regarding types of animals, surgical procedures, monitoring, and methods of assessment. Conclusion: The aim of this study was to select the most suitable SBS model regarding the purpose of the research.

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“…(14). It has been noticed if the patient is started on an enteral diet at the earliest, intestinal adaptation is faster as it results in intestinal luminal stimulation (15).…”

Section: Adaptation Phasementioning

confidence: 99%