The effects of diet on the residual small intestine following massive resection

Soy-polysaccharide-supplemented soy formula enhances mucosal disaccharidase levels following massive small intestinal resection in rats

BACKGROUND

Addition of soy polysaccharide to infant formulas has previously been shown to reduce the duration of diarrhea in infants with acute gastroenteritis. Fiber is metabolized to short-chain fatty acids that have been shown to be beneficial in inducing adaptation in the small bowel. We therefore hypothesize that a soy-polysaccharide-supplemented infant formula may be potentially advantageous in the treatment of patients with short bowel syndrome and could have a trophic effect on the remaining small intestine.

METHODS

Male Spraque-Dawley rats weighing 250 g were divided into two groups. One group received Isomil, a standard infant soy formula. The second group received Isomil supplemented with fiber, Isomil DF. Half the animals in each dietary group were subjected to 80% jejunoileal resection and the reminder were sham operated. Animals were pair-fed one of two diets for 14 days. At the conclusion of the 14-day period, mucosal weight and sucrase and lactase levels in the remaining duodenum and ileum were determined.

RESULTS

Resected animals fed fiber-supplemented formulas had significantly higher sucrase and lactase levels in the proximal bowel. Comparable results were not observed in the sham-operated animals.

CONCLUSIONS

The addition of soy polysaccharide to infant formulas fed to children with short bowel syndrome might potentially improve small intestinal functional adaptation as well as positively affecting stool consistency.

Harry M. Vars award. Glutamine or fiber supplementation of a defined formula diet: impact on bacterial translocation, tissue composition, and response to endotoxin

Despite provision of adequate calories, defined formula diets in rats lead to bacterial translocation (BT), fatty infiltration of the liver, and an increased susceptibility to endotoxin. These deleterious effects may be due in part to a loss of intestinal barrier integrity resulting from bowel atrophy. Defined formula diets lack both glutamine and fiber, substances which may help maintain intestinal mass. To determine whether supplementation of defined formula diets with either glutamine or fiber might prevent bowel atrophy and, thus, BT, hepatic steatosis, and the altered response to endotoxin, Wistar rats were fed (1) defined formula diet ad libitum (DFD), (2) (DFD + 2% (w/v) glutamine, (GLUT), or (3) DFD + 2% (w/v) psyllium (FIBER). Rats given standard food isocalorically pair-fed to DFD were used as controls. Nutritional status was assessed by daily weight gain, as well as the ability to maintain serum albumin, hematocrit and white blood counts. After 2 weeks of these feeding regimens, animals were sacrificed, and organ weights and composition were determined, with rates of bacterial translocation determined by mesenteric lymph node, abdominal viscera, and cecal cultures. Additional animals receiving the same experimental diets were subsequently challenged with endotoxin and observed for mortality with rates of post-endotoxin BT and the responses of acute phase proteins and cytokines measured. All dietary regimens resulted in equivalent weight gain and other nutritional parameters. Both glutamine and fiber supplementation maintained small bowel mass, but only GLUT preserved normal jejunal mucosal architecture. Neither fiber nor glutamine supplementation prevented cecal bacterial overgrowth or BT, resulting from the DFD.(ABSTRACT TRUNCATED AT 250 WORDS)