Role of the Ileocecal Valve and Site of Intestinal Resection in Malabsorption after Extensive Small Bowel Resection

Digestion ◽  
1978 ◽  
Vol 18 (5-6) ◽  
pp. 329-336 ◽  
Author(s):  
J. Cosnes ◽  
J.P. Gendre ◽  
Y. Le Quintrec
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Ileocecal Valve ◽  
Small Bowel Resection

scholarly journals The role of humoral factors and the ileocecal valve in pathological changes occurring after distal small bowel resection.

1987 ◽  
Vol 151 (2) ◽  
pp. 155-168 ◽  
Author(s):  
MIKIO IMAMURA ◽  
MORIHIKO TODA ◽  
YOSHIROO SUZUKI ◽  
IWAO SASAKI ◽  
TOSHIO SATO ◽  
...  
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Ileocecal Valve ◽  
Small Bowel Resection ◽  
Pathological Changes ◽  
Humoral Factors ◽  
Distal Small Bowel

Role of gastrin in gastrointestinal adaptation after small bowel resection

1982 ◽  
Vol 243 (1) ◽  
pp. G16-G20
Author(s):  
A. B. Dembinski ◽  
L. R. Johnson
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Ileal Mucosa ◽  
Proximal Small Intestine ◽  
Total Dna ◽  
Oxyntic Gland ◽  
Trophic Hormone

Gastrin is a trophic hormone for the mucosa of the oxyntic gland area of the stomach, the proximal small intestine, and the colon. It also has trophic effects on the pancreas. All these tissues undergo hyperplasia to some extent following distal small bowel resection. This study evaluates the role of gastrin in postresectional hyperplasia by examining the growth of these tissues in antrectomized rats following intestinal resection. Antrectomy itself caused atrophy of the oxyntic gland mucosa, colonic mucosa, and the pancreas but had no effect on ileal mucosa. Resection by itself stimulated growth of all tissues and significantly increased serum gastrin levels. After resection in antrectomized animals, all tissues underwent an adaptational response. The increase in total DNA content after resection in antrectomized rats was as great in all tissues, except the colon, as it was in animals with intact antrums and normal gastrin levels. These results indicate that gastrin plays no role in the postresectional hyperplasia observed in the various tissues of the gastrointestinal tract.

Pathophysiological correlates of two unique renal tubule lesions in rats with intestinal resection

2006 ◽  
Vol 291 (5) ◽  
pp. F1061-F1069 ◽  
Author(s):  
Elaine Worcester ◽  
Andrew Evan ◽  
Sharon Bledsoe ◽  
Mark Lyon ◽  
Mark Chuang ◽  
...  
Keyword(s):  
Calcium Phosphate ◽  
Small Bowel ◽  
Bowel Resection ◽  
Cell Damage ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Renal Tissue ◽  
Apical Surface ◽  
Crystal Deposition ◽  
Oxalate Excretion

Rats with small bowel resection fed a high-oxalate diet develop extensive deposition of calcium oxalate (CaOx) and calcium phosphate crystals in the kidney after 4 mo. To explore the earliest sites of renal crystal deposition, rats received either small bowel resection or transection and were then fed either standard chow or a high-oxalate diet; perfusion-fixed renal tissue from five rats in each group was examined by light microscopy at 2, 4, 8, and 12 wk. Rats fed the high-oxalate diet developed birefringent microcrystals at the brush border of proximal tubule cells, with or without cell damage; the lesion was most common in rats with both resection and a high-oxalate diet (10/19 with the lesion) and was significantly correlated with urine oxalate excretion ( P < 0.001). Rats with bowel resection fed normal chow had mild hyperoxaluria but high urine CaOx supersaturation; four of these rats developed birefringent crystal deposition with tubule plugging in inner medullary collecting ducts (IMCD). Two rats fed a high-oxalate diet also developed this lesion, which was correlated with CaOx supersaturation, but not oxalate excretion. Tissue was examined under oil immersion, and tiny birefringent crystals were noted on the apical surface of IMCD cells only in animals with IMCD crystal plugging. In one animal, IMCD crystals were both birefringent and nonbirefringent, suggesting a mix of CaOx and calcium phosphate. Overall, these animals demonstrate two distinct sites and mechanisms of renal crystal deposition and may help elucidate renal lesions seen in humans with enteric hyperoxaluria and stones.

Gut adaptation and the insulin-like growth factor system: regulation by glutamine and IGF-I administration

1996 ◽  
Vol 271 (5) ◽  
pp. G866-G875 ◽  
Author(s):  
T. R. Ziegler ◽  
M. P. Mantell ◽  
J. C. Chow ◽  
J. L. Rombeau ◽  
R. J. Smith
Keyword(s):  
Growth Factor ◽  
Small Bowel ◽  
Dna Content ◽  
Bowel Resection ◽  
Synergistic Effects ◽  
Intestinal Adaptation ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Insulin Like Growth Factor ◽  
Igf I

Intestinal adaptation after extensive small bowel resection in rats is augmented by the provision of diets supplemented with the amino acid glutamine (Gln) or by administration of insulin-like growth factor-I (IGF-I). The goal of this study was to investigate potential synergistic effects of Gln and IGF-I on postresection ileal hyperplasia. Rats underwent 80% small bowel resection (SBR) and then were fed low-Gln or L-Gln-enriched diets and subcutaneously given recombinant human IGF-I or vehicle for 7 days. Gln and IGF-I each significantly enhanced adaptive ileal hyperplasia (DNA content) compared with rats receiving vehicle and low-Gln diet. Ileal DNA content was highest when IGF-I was administered together with Gln supplementation. Combined IGF-I plus Gln synergistically increased ileal weight and protein content. This was associated with higher plasma concentrations of IGF-I and Gln than observed when IGF-I or Gln was given individually. Ileal IGF-I mRNA expression rose nearly twofold during gut adaptation after SBR; this response was augmented with IGF-I administration but was unaltered by Gln feeding. In contrast, dietary Gln, but not IGF-I therapy, prevented a decrease in hepatic IGF-I mRNA induced by SBR. We conclude that parenteral IGF-I and enteral Gln have both individual and synergistic effects on ileal adaptation after massive small intestinal resection. These findings support the concept that specific gut-trophic nutrients and growth factors may be combined to enhance intestinal adaptation and possibly reduce the severity of short bowel syndrome after intestinal resection.

scholarly journals Novel goblet cell gene related to IgGFcγBP is regulated in adapting gut after small bowel resection

2000 ◽  
Vol 279 (5) ◽  
pp. G1003-G1010 ◽  
Author(s):  
Deborah C. Rubin ◽  
Elzbieta A. Swietlicki ◽  
Hristo Iordanov ◽  
Christine Fritsch ◽  
Marc S. Levin
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Molecular Regulation ◽  
Mrna Levels ◽  
Small Intestinal ◽  
Cell Gene ◽  
Rat Gut

The loss of functional small bowel surface area leads to a well-described adaptive response in the remnant intestine. To elucidate its molecular regulation, a cohort of cDNAs were cloned using a rat gut resection model and subtractive/differential hybridization cloning techniques. This study reports a novel cDNA termed “ileal remnant repressed” (IRR)-219, which shares 80% nucleotide identity with the 3′end of a human intestinal IgG Fc binding protein (IgGFcγBP) and is homologous to human and rat mucins. IRR-219 mRNA is expressed in intestine and colon only. At 48 h after 70% intestinal resection, mRNA levels decreased two- to fivefold in the adaptive small bowel but increased two- to threefold in the colon. Expression of IRR-219 was suppressed in adaptive small bowel as late as 1 wk after resection. IRR-219 expression is also regulated during gut ontogeny. In situ hybridization revealed IRR-219 expression in small intestinal and colonic goblet cells only. Its unique patterns of expression during ontogeny and after small bowel resection suggest distinctive roles in small bowel and colonic adaptation.

In vivo zinc transport by rat small intestine after extensive small bowel resection

1984 ◽  
Vol 247 (1) ◽  
pp. G88-G94
Author(s):  
E. Urban ◽  
M. E. Campbell
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Segment Length ◽  
Zinc Transport ◽  
Entry And Exit ◽  
Segment Transport ◽  
Specific Activities

We studied the effects of intestinal resection on in vivo zinc transport and intestinal tissue zinc in remnant duodenum and ileum 4 wk after two-thirds small bowel enterectomy. In situ duodenal and ileal intestinal segments from resected and sham-operated control rats were perfused through the lumen with an isotonic solution containing 0.077 mM zinc with isotopic 65Zn as tracer. After resection there was significant mucosal growth in both segments, but segment transport specific activities (transport per gram mucosa) were unchanged. Therefore, increased segment transport capacities (transport per centimeter segment length) in both segments approximated increased mucosal mass. Comparisons with transport data from our earlier studies on other luminal substrates in rats after small bowel resection showed that adaptive transport mechanisms vary not only with the luminal substrate examined but may also differ in remaining proximal and distal small bowel. In the present study about 12% of the absorbed radiotracer zinc remained in the intestinal wall after perfusion of both duodenum and ileum of resected and control animals, and there were no effects of resection on tissue radiotracer 65Zn concentrations or specific activities in the mucosal fraction or underlying tissues. Calculations of mucosal entry and exit fluxes per centimeter segment length showed that the major effect of resection was to increase the zinc entry flux at the luminal surface of the mucosa. At the basal surface of the mucosa, both entry and exit fluxes increased.(ABSTRACT TRUNCATED AT 250 WORDS)

The role of apoptosis during intestinal adaptation after small bowel resection

2000 ◽  
Vol 35 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Carlo F.M. Welters ◽  
Femke E. Piersma ◽  
David M. Hockenbery ◽  
Erik Heineman Maastricht
Keyword(s):  
Small Bowel ◽  
Bowel Resection ◽  
Intestinal Adaptation ◽  
Small Bowel Resection

Effects of bile and pancreatic secretions on intestinal mucosa after proximal small bowel resection in rats

1980 ◽  
Vol 58 (9) ◽  
pp. 1117-1123 ◽  
Author(s):  
Monique D. Gélinas ◽  
Claude L. Morin
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Pancreatic Juice ◽  
Bowel Resection ◽  
Intestinal Resection ◽  
Small Bowel Resection ◽  
Sprague Dawley ◽  
Ileal Mucosa ◽  
Distal Small Intestine ◽  
Proximal Small Bowel

After proximal small bowel resection the remaining small intestine undergoes adaptive hyperplasia. In the present study, the relative contributions of bile and (or) pancreatic juice to adaptive intestinal hyperplasia following proximal resection was studied. Using male Sprague–Dawley rats a 50% proximal intestinal resection was done starting 10 cm distal to the beginning of the jejunum. The animals were also subjected to diversion of bile and (or) pancreatic secretions to the distal ileum at 18 cm proximal to the ileocecal junction. After 8 days gut and mucosal weights, mucosal proteins, and DNA were measured in the duodenojejunum (gut segment proximal to the resection anastomosis) and in the ileum (first half of the small bowel segment distal to the diversion site). The results indicate that (1) in rats fed either chow (Purina rat chow) or a chemically defined diet diversion of pancreaticobiliary secretions to the ileum significantly stimulated ileal mucosa growth whereas no changes were observed in the duodenojejunum, (2) in rats fed a chemically defined diet neither bile nor pancreatic juice affected ileal mucosa when separately diverted to the ileum, and (3) pancreatic juice draining into the duodenum while bile was diverted to the ileum induced hypoplastic changes in the duodenojejunum. The present study suggests that following jejunectomy the regulation of mucosal growth by pancreatic and bile secretions is different in the proximal and distal small intestine. Pancreaticobiliary secretions are trophic for the ileum. However, in the proximal gut bile offers protection against a direct or indirect catabolic action of pancreatic juice.

Role of luminal nutrients and endogenous GLP-2 in intestinal adaptation to mid-small bowel resection

2003 ◽  
Vol 284 (4) ◽  
pp. G670-G682 ◽  
Author(s):  
Elizabeth M. Dahly ◽  
Melanie B. Gillingham ◽  
Ziwen Guo ◽  
Sangita G. Murali ◽  
David W. Nelson ◽  
...  
Keyword(s):  
Small Bowel ◽  
Adaptive Response ◽  
Bowel Resection ◽  
Intestinal Adaptation ◽  
Small Bowel Resection ◽  
Oral Feeding ◽  
Enterocyte Proliferation ◽  
Glucagon Like Peptide ◽  
Mucosal Growth

To elucidate the role of luminal nutrients and glucagon-like peptide-2 (GLP-2) in intestinal adaptation, rats were subjected to 70% midjejunoileal resection or ileal transection and were maintained with total parenteral nutrition (TPN) or oral feeding. TPN rats showed small bowel mucosal hyperplasia at 8 h through 7 days after resection, demonstrating that exogenous luminal nutrients are not essential for resection-induced adaptation when residual ileum and colon are present. Increased enterocyte proliferation was a stronger determinant of resection-induced mucosal growth in orally fed animals, whereas decreased apoptosis showed a greater effect in TPN animals. Resection induced significant transient increases in plasma bioactive GLP-2 during TPN, whereas resection induced sustained increases in plasma GLP-2 during oral feeding. Resection-induced adaptive growth in TPN and orally fed rats was associated with a significant positive correlation between increases in plasma bioactive GLP-2 and proglucagon mRNA expression in the colon of TPN rats and ileum of orally fed rats. These data support a significant role for endogenous GLP-2 in the adaptive response to mid-small bowel resection in both TPN and orally fed rats.

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