Intestinal absorption of free oral hyperalimentation in the very short bowel syndrome

Messing, Bernard; Pigot, F.; Rongier, M.; Morin, Marie‐Christine; Ndeïndoum, Urbain; Rambaud, J.-C.

doi:10.1016/0016-5085(91)90645-2

Cited by 148 publications

(66 citation statements)

References 23 publications

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“…Compared to healthy volunteers, the apparent digestibility of energy, fat and protein was significantly lower in patients with SBC, whereas there was no significant difference for the apparent digestibility of CHO. These data also agree with previous studies performed in patients with SBC (Woolf et al, 1983;Messing et al, 1991;Nordgaard et al, 1994).…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Faecal bacterial mass and energetic losses in healthy humans and patients with a short bowel syndrome

Achour¹,

Nancey

Moussata

et al. 2006

Eur J Clin Nutr

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Objective: In addition to non-digested nutrients, human stools contain endogenous substrates, among which bacteria are a major component, whose growth may be stimulated when more dietary nutrients are available for bacterial fermentation, as in patients with malabsorption syndrome. We assessed the energy content and composition of both stools and faecal bacteria in healthy volunteers and patients with a short bowel and colon in continuity (SBC). Our goal was to clarify the magnitude of error introduced by the faecal bacteria in the measurement of the digestibility of ingested energy and nutrients. Subjects and methods: We studied six healthy volunteers and six patients with a SBC under free oral intake. The bacterial mass of stools was isolated. In the bacterial fractions and fresh stools, calorie, fat, nitrogen and short-chain fatty acid contents were determined. The Wilcoxon signed rank or the Mann-Whitney tests were used for comparison. Results: In healthy volunteers and patients with SBC, faecal bacterial mass accounted for 44 and 35% of faecal dry weight, and contained 50 and 34% of total faecal energy. In healthy volunteers, the apparent digestibilities when corrected by bacterial constituents (88-97% according to nutrients) were significantly higher than the apparent non-corrected digestibilities (84-94%). In patients with SBC, the corrected apparent digestibilities (69-89% according to nutrients) were significantly higher than the apparent non-corrected digestibilities (54-83%). Conclusion: The error introduced by the faecal bacterial fraction when assessing the extent of nutrient digestibility is small in healthy volunteers; it is more pronounced in patients with SBC, reaching 18% for the digestibility of ingested fat.

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Section: Discussionsupporting

confidence: 93%

“…Faecal energy losses are low in healthy subjects (Southgate and Durnin, 1970), but increase in patients with intestinal malabsorption. For example, faecal energy losses can reach the third of oral energy intakes in patients with the short bowel syndrome (Messing et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Faecal bacterial mass and energetic losses in healthy humans and patients with a short bowel syndrome

Achour¹,

Nancey

Moussata

et al. 2006

Eur J Clin Nutr

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“…Woolf et al reported spontaneous intake of 31 ± 3 kcal/kg/day (range, 16 to 38 kcal/kg/day) in 10 Canadian patients with SBS, only 2 of whom were PN-dependent (34). Ovesen reported habitual oral calorie intake of 5 PN-dependent SBS patients with a jejunostomy living in the United States to average 1900 kcal/day (range 600 to 3300 kcal/day), intake similar to our study subjects (Table 3 (35)(36) did not find any difference in oral intake between patients with or without PN, Jeppesen observed higher oral energy intake in 44 Danish SBS patients not dependent on PN (median ~ 2780 kcal/day) compared to that of 45 PN-dependent patients (~ 1800 kcal/day) (37). Our PN-dependent subjects spontaneous oral intake averaged 2656±242 kcal/day.…”

Section: Discussionsupporting

confidence: 77%

“…Hyperphagia is necessary for many SBS patients to avoid PN-dependency (35)(36)(37). PN also appears to induce satiety in some individuals.…”

Section: Discussionmentioning

confidence: 99%

Nutrient intake from habitual oral diet in patients with severe short bowel syndrome living in the southeastern United States

et al. 2008

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“…5 SBS patients are generally encouraged to compensate for malabsorption by implementing a degree of hyperphagia. 6,7 Treatment strategies have included changes in diet composition, for example, high-carbohydrate and low fat-diets 8 or addition of single nutrients such as glutamine, 9 medium chain triglycerides 10 or bile acids. 11 Continuous enteral hyperalimentation has been suggested to improve macronutrient absorption, 7,12 but the associated effects on fluid and electrolyte absorption are not clear.…”

Section: Introductionmentioning

confidence: 99%

Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome

et al. 2012

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BACKGROUND/OBJECTIVES: Colostrum is rich in immunoregulatory, antimicrobial and trophic components supporting intestinal development and function in newborns. We assessed whether bovine colostrum could enhance intestinal adaptation and function in adult short bowel syndrome (SBS) patients. SUBJECTS/METHODS: Twelve SBS patients in this randomised cross-over study received 4 weeks oral supplement of bovine colostrum or an iso-energetic and iso-proteinaceous control (2.4 MJ/d, 500 ml/day) separated by a 4-week washout period. Patients were admitted four times for 72-h periods of fluid, electrolyte and nutrient balance studies. Meals, faeces and urine were weighed, and energy, macronutrient and electrolyte contents were analysed to calculate net nutrient uptake. Body composition was measured by dual-energy X-ray absorptiometry scans, and functional tests of handgrip strength and lung functions were performed. Eight patients completed the study and were included in the analysis. RESULTS: Both supplements (colostrum and control) not only increased protein (0.96±0.42 MJ/d, P ¼ 0.004 1.03±0.44 MJ/d, P ¼ 0.003) and energy (1.46±1.02 MJ/d, P ¼ 0.005, 1.76±1.46 MJ/d, P ¼ 0.01) absorption but also absolute faecal wet weight excretions (231 ± 248 g/d, P ¼ 0.002, 319 ± 299 g/d, P ¼ 0.03), compared with baseline measurements. Both supplements improved handgrip strength (P ¼ 0.03) while only the control supplement increased lean body mass (1.12±1.33 kg, Po0.049). Colostrum was not found to be superior to the control. CONCLUSION: Intake of high-protein milk supplements increased net nutrient absorption for adult SBS patients, but at the expense of increased diarrhoea. Despite high contents of bioactive factors, colostrum did not significantly improve intestinal absorption, body composition or functional tests compared with the control.

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Intestinal absorption of free oral hyperalimentation in the very short bowel syndrome

Cited by 148 publications

References 23 publications

Faecal bacterial mass and energetic losses in healthy humans and patients with a short bowel syndrome

Faecal bacterial mass and energetic losses in healthy humans and patients with a short bowel syndrome

Nutrient intake from habitual oral diet in patients with severe short bowel syndrome living in the southeastern United States

Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome

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