Absorption and secretion by the colon

Altered intestinal epithelial nutrient transport: an underappreciated factor in obesity modulated by diet and microbiota

Dietary nutrients absorbed in the proximal small intestine and assimilated in different tissues have a profound effect on overall energy homeostasis, determined by a balance between body's energy intake and expenditure. In obesity, altered intestinal absorption and consequently tissue assimilation of nutrients may disturb the energy balance leading to metabolic abnormalities at the cellular level. The absorption of nutrients such as sugars, amino acids and fatty acids released from food digestion require high-capacity transporter proteins expressed in the intestinal epithelial absorptive cells. Furthermore, nutrient sensing by specific transporters/receptors expressed in the epithelial enteroendocrine cells triggers release of gut hormones involved in regulating energy homeostasis via their effects on appetite and food intake. Therefore, the intestinal epithelial cells play a pivotal role in the pathophysiology of obesity and associated complications. Over the past decade, gut microbiota has emerged as a key factor contributing to obesity via its effects on digestion and absorption of nutrients in the small intestine, and energy harvest from dietary fiber, undigested component of food, in the large intestine. Various mechanisms of microbiota effects on obesity have been implicated. However, the impact of obesity-associated microbiota on the intestinal nutrient transporters needs extensive investigation. This review marshals the limited studies addressing the altered structure and function of the gut epithelium in obesity with special emphasis on nutrient transporters and role of diet and microbiota. The review also discusses the thoughts and controversies and research gaps in this field.

Colonic Absorption of Low-Molecular-Weight Metabolites Influenced by the Intestinal Microbiome: A Pilot Study

Low-molecular-weight metabolites produced by the intestinal microbiome play a direct role in health and disease. However, little is known about the ability of the colon to absorb these metabolites. It is also unclear whether these metabolites are bioavailable. Here, metabolomics techniques (capillary electrophoresis with time-of-flight mass spectrometry, CE-TOFMS), germ-free (GF) mice, and colonized (Ex-GF) mice were used to identify the colonic luminal metabolites transported to colonic tissue and/or blood. We focused on the differences in each metabolite between GF and Ex-GF mice to determine the identities of metabolites that are transported to the colon and/or blood. CE-TOFMS identified 170, 246, 166, and 193 metabolites in the colonic feces, colonic tissue, portal plasma, and cardiac plasma, respectively. We classified the metabolites according to the following influencing factors: (i) the membrane transport system of the colonocytes, (ii) metabolism during transcellular transport, and (iii) hepatic metabolism based on the similarity in the ratio of each metabolite between GF and Ex-GF mice and found 62 and 22 metabolites that appeared to be absorbed from the colonic lumen to colonocytes and blood, respectively. For example, 11 basic amino acids were transported to the systemic circulation from the colonic lumen. Furthermore, many low-molecular-weight metabolites influenced by the intestinal microbiome are bioavailable. The present study is the first to report the transportation of metabolites from the colonic lumen to colonocytes and somatic blood in vivo, and the present findings are critical for clarifying host-intestinal bacterial interactions.

The importance of the gastrorenal axis in the control of body sodium homeostasis

NEW FINDINGS

What is the topic of this review? Sensing the amount of ingested sodium is one mechanism by which sodium balance is regulated. This review describes the role of gastrin in the cross-talk between the stomach and the kidney following the ingestion of sodium. What advances does it highlight? Neural mechanisms and several gut hormones, including cholecystokinin and uroguanylin, have been suggested to mediate the natriuresis after an oral sodium load. It is proposed that gastrin produced by G-cells via its receptor, cholecystokinin B receptor, interacts with renal D1 -like dopamine receptors to increase renal sodium excretion. Hypertension develops with chronically increased sodium intake when sodium that accumulates in the body can no longer be sequestered, extracellular fluid volume is expanded, and compensatory neural, hormonal and pressure-natriuresis mechanisms fail. Sensing the amount of ingested sodium, by the stomach, is one mechanism by which sodium balance is regulated. The natriuresis following the ingestion of a certain amount of sodium may be due to an enterokine, gastrin, secreted by G-cells in the stomach and duodenum and released into the circulation. Circulating gastrin levels are 10- to 20-fold higher than those for cholecystokinin. Of all the gut hormones circulating in the plasma, gastrin is the one that is reabsorbed to the greatest extent by renal tubules. Gastrin, via its receptor, the cholecystokinin type B receptor (CCKBR), is natriuretic in mammals, including humans, by inhibition of renal sodium transport. Germline deletion of gastrin (Gast) or Cckbr gene in mice causes salt-sensitive hypertension. Selective silencing of Gast in the stomach and duodenum impairs the ability to excrete an oral sodium load and also increases blood pressure. Thus, the gastrorenal axis, mediated by gastrin, can complement pronatriuretic hormones, such as dopamine, to increase sodium excretion after an oral sodium load. These studies in mice may be translatable to humans because the chromosomal loci of CCKBR and GAST are linked to human essential hypertension. Understanding the role of genes in the regulation of renal function and blood pressure may lead to the tailoring of antihypertensive treatment based on genetic make-up.

Dietary fibre and the importance of the gut microbiota in feline nutrition: a review

Domestic cats are obligate carnivores and in this light hindgut fermentation has been considered unimportant in this species. However, a diverse microbiota has been found in the small and large intestines of domestic cats. Additionally, in vitro and in vivo studies support the hypothesis that microbial fermentation is significant in felines with potential benefits to the host. Results on microbiota composition and microbial counts in different regions of the feline gastrointestinal tract are compiled, including a description of modulating host and technical factors. Additionally, the effects of dietary fibre supplementation on the microbiota composition are described. In a second section, in vitro studies, using inocula from fresh feline faeces and focusing on the fermentation characteristics of diverse plant substrates, are described. In vivo studies have investigated the effects of dietary fibre on a broad range of physiological outcomes. Results of this research, together with studies on effects of plant fibre on colonic morphology and function, protein and carbohydrate metabolism, and the effects of plant fibre on disease conditions that require a decrease in dietary protein intake, are shown in a third section of the present review. Conclusively, for fructans and beet pulp, for example, diverse beneficial effects have been demonstrated in the domestic cat. Both dietary fibre sources are regularly used in the pet food industry. More research is warranted to reveal the potential benefits of other fibre sources that can be used on a large scale in feline diets for healthy and diseased cats.

Adiponectin receptor 2 is negatively associated with lymph node metastasis of colorectal cancer

Adiponectin is a hormone secreted by adipose tissue and has a variety of functions including the inhibition of tumor growth. The expression and function of the two major adiponectin receptors, AdipoR1 and AdipoR2, in malignant tissue have not been well characterized. In the present study, we evaluated the mRNA levels of AdipoR1 and AdipoR2 expression in 48 surgically resected colorectal cancer specimens, as well as normal colonic mucosa, by quantitative RT-PCR. The values obtained were standardized by β-actin mRNA, and the correlation between their relative expression levels and the clinicopathological characteristics of the patients was examined. The relative expression levels of AdipoR1 and AdipoR2 were significantly reduced in cancer tissue compared with normal tissue (AdipoR1: 0.97±0.39 vs. 1.37±0.41, P<0.0001; AdipoR2: 0.92±0.31 vs. 1.60±0.46, P<0.0001). AdipoR1 and AdipoR2 levels were further reduced in tumors with nodal metastases and the difference was statistically significant in the case of AdipoR2 (0.79±0.27 vs. 1.02±0.30, P=0.012). The results of this study demonstrated that the expression levels of adiponectin receptors are reduced in cancer specimens compared to normal tissue, indicating a downregulation in the course of the development and progression of colorectal cancer. Since adiponectin is abundantly present in the whole body and has inhibitory effects on cancer cells, this downregulation of the receptors may be an escape mechanism of malignant cells from the suppressive effects of adiponectin.

Understanding changes in uptake and release of serotonin from gastrointestinal tissue using a novel electroanalytical approach

Serotonin (5-HT) is well known to be a key neurotransmitter within the gastrointestinal (GI) tract, where it is responsible for influencing motility. Obtaining dynamic information about the neurotransmission process (specifically the release and reuptake of 5-HT) requires the development of new approaches to measure the extracellular 5-HT concentration profile. In this work constant-potential amperometry has been utilised at +650 mV vs. Ag|AgCl to measure in vitro the overflow of 5-HT. Steady-state levels of 5-HT have been observed, due to continuous mechanical stimulation of the tissue from the experimental protocol. Measurements are conducted at varying tissue-electrode distances in the range of 5 to 1100 microm. The difference in the current from the bulk media and that from each tissue-electrode distance is obtained, and the natural log of this current is plotted versus the tissue-electrode distance. The linear fit to the log of the current is derived, and its intercept, I(0), with the vertical axis and its slope are calculated. The reciprocal of the slope, indicated as slope(-1), is used as a marker of reuptake. The ratio between intercept, I(0), and the reciprocal of the slope, I(0)/slope(-1), is a measure of the flux at the tissue surface and it can be used as a marker for the 5-HT release rate. Current measurements for ileum and colon tissue indicated a significantly higher reuptake rate in the colon, showed by a lower slope(-1). In addition, the ratio, I(0)/slope(-1), indicated that the colon has a higher 5-HT flux compared to the ileum. Following the application of the serotonin selective reuptake inhibitor (SSRI), fluoxetine, both tissues showed a higher value of slope(-1), as the reuptake process is blocked preventing clearance of 5-HT. No differences were observed in the ratio, I(0)/slope(-1), in the ileum, but a decrease was observed in the colon. These results indicate that ileum and colon are characterised by different reuptake and release processes. The new approach we propose provides pivotal information on the variations in the signalling mechanism, where steady state levels are observed and can be a vital tool to study differences between normal and diseased tissue and also the efficacy of pharmacological agents.

Acidic fermentation in the caecum increases absorption of calcium and magnesium in the large intestine of the rat

The effect of fermentation on colonic absorption of Ca and Mg was investigated in 8-week-old rats adapted to diets containing either digestible wheat starch (DS diets) or including resistant starch, i.e. 350 g raw potato starch/kg (RS diets). The dietary Ca level of the DS and RS diets was 2·5 or 7·5 g/kg. RS diets resulted in enlargements of the caecum together with hypertrophy of the caecal wall. Acidification of the caecal contents by mictobial fermentation of RS was influenced by the dietary Ca level. Very acidic pH conditions and relatively low concentrations of short-chain fatty acids, in the presence of lactic acid fermentation, were observed with the 2·5 g Ca/kg level. Rats fed on RS diets had a bhigher pencentage of soluble Ca (and inorganic phosphate) in the caecum, particularly of rats adapted to the high Ca level. As a result of the hypertrophy of the caecal wall and of an elevated concentration of soluble Cas, the caecal absorption of Ca was 5-6 fold higher in the RS groups than in the DS groups. The difference between dietary intakle and faecal excretion (DI-FE) of Ca was higher in rats fed on RS diets than in those fed on DS diets, when the dietary Ca level was 2·5 g/kg. With the higher Ca intake the elevated rate of Ca absorption from the caecum in RS-fed rats was not paralleled by an enhanced DI-EE difference: this suggests a shift of the Ca absorption towards the large intestine. Feeding Rs diets also enhanced Mg caecal absorption, resulting in the substatntially higher DI-FE difference for Mg, especially with the 2·5 g Ca/kg diets, because a high Ca intake tends to inhibit Mg absorption. The present findings support the view that the large intestine may represent a major site of Ca (and Mg) absorption when acidic fermentations take place. This process could improve the digestive Ca balance when the dietary Ca supply is low; when the Ca supply is affluent, it rather shits Ca absorption towards a more distal site fo the digestive tract.

A physiological model for the estimation of the fraction dose absorbed in humans

A physiologically based model for gastrointestinal transit and absorption in humans is presented. The model can be used to study the dependency of the fraction dose absorbed (F(abs)) of both neutral and ionizable compounds on the two main physicochemical input parameters (the intestinal permeability coefficient (P(int)) and the solubility in the intestinal fluids (S(int))) as well as physiological parameters such as the gastric emptying time and the intestinal transit time. For permeability-limited compounds, the model produces the established sigmoidal dependence between F(abs) and P(int). In case of solubility-limited absorption, the model enables calculation of the critical mass-solubility ratio, which defines the onset of nonlinearity in the response of fraction absorbed to dose. In addition, an analytical equation to calculate the intestinal permeability coefficient based on the compound's membrane affinity and molecular weight was used successfully in combination with the physiologically based pharmacokinetic (PB-PK) model to predict the human fraction dose absorbed of compounds with permeability-limited absorption. Cross-validation demonstrated a root-mean-square prediction error of 7% for passively absorbed compounds.

A role for a galactose lectin and its ligands during encystment of Entamoeba

In the life cycle of Entamoeba parasites alternate between the colon-dwelling trophozoite and the infectious cyst forms. The physiologic stimuli that trigger differentiation of trophozoites into cysts remain undefined. On the surface of the human-infecting Entamoeba, parasites express a galactose/N-acetylgatactosamine (gal/galNAc)-binding lectin, which plays demonstrated roles in contact-dependent lysis of target cells and resistance to host complement. Using a reptilian parasite, Entamoeba invadens, to study cyst formation in vitro, we found that efficient encystation was dependent on the presence of gal-terminated ligands in the induction medium. Precise concentration ranges of several gal-terminated ligands, such as asialofetuin, gal-bovine serum albumin (gal-BSA), and mucin, functioned in encystation medium to stimulate differentiation. Greater than 10 mM levels of free gal inhibited the amoeba aggregation that precedes encystation and prevented formation of mature cysts. Inhibitory levels of gal also prevented the up-regulation of genes which normally occurs at 24 h of encystation. The surface of Entamoeba invadens was found to express a gal lectin which has a heterodimeric structure similar to that of Entamoeba histolytica. The 30 kDa light subunit (LGL) of the E. invadens lectin is similar in overall size and sequence to the LGL of E. histolytica. The heavy subunits, however, differ in size, have an identical spacing of cysteines in their extracellular domains, and have highly conserved C-terminal transmembrane and cytoplasmic domains. These results suggest a new role for the Entamoeba gal lectins in monitoring the concentrations of gal ligands in the colon and contributing to stimuli that induce encystment.

Role of fermentable carbohydrate supplements with a low-protein diet in the course of chronic renal failure: experimental bases

During the past few years, considerable attention has been given to the impact of nutrition on kidney disease. The question arises of whether the effect of a moderate dietary protein restriction could be reinforced by enrichment of the diet with fermentable carbohydrates. Feeding fermentable carbohydrates may stimulate the extrarenal route of nitrogen (N) excretion through the fecal route. Such an effect has been reported in several species, including healthy humans and patients with chronic renal failure (CRF). Furthermore, studies of these subjects show that the greater fecal N excretion during the fermentable carbohydrate supplementation period was accompanied by a significant decrease in plasma urea concentration. In animal models of experimental renal failure, the consumption of diets containing fermentable carbohydrates results in a greater rate of urea N transfer from blood to the cecal lumen, where it is hydrolyzed by bacterial urease before subsequent microflora metabolism and proliferation. Therefore, this results in a greater fecal N excretion, coupled with a reduction in urinary N excretion and plasma urea concentration. Because elevated concentrations of serum urea N have been associated with adverse clinical symptoms of CRF, these results suggest a possible usefulness of combining fermentable carbohydrates with a low-protein diet to increase N excretion through the fecal route. Further investigations in this population of patients of whether fermentable carbohydrates in the diet may be beneficial in delaying or treating the symptoms and chronic complications of CRF will certainly emerge in the future. This should be realized without adversely affecting nutritional status and, as far as possible, by optimizing protein intake for the patients without being detrimental to renal function.

Faecal concentrations and production rates of short chain fatty acids in normal neonates

Changes in intestinal microbial flora are reflected in the faecal concentrations and production rates of short chain fatty acids. However, since no data on the latter are available in neonates, the aim of this study is to provide information on short chain fatty acids in faeces from normal neonates. Faecal samples were collected immediately after birth (meconium) and on the 4th day of life in 13 healthy, full-term neonates. The production capacity was evaluated by a faecal incubation system. Concentrations of short chain fatty acids were low in meconium (11.2 + 3.9 mmol/l (mean +/- SD], equivalent to about 10% of the adult level (p less than 0.01), but increased significantly during the first 4 days of life to 28.4 +/- 20.1 mmol/l (p less than 0.05). The fermentation pattern (i.e. relative composition of different acids) showed differences between adults and neonates, primarily due to a higher proportion of acetate found in the latter. The ratio acetate/propionate/butyrate/other acids was 89/5/5/1 in 4-day-old neonates compared to 65/18/11/6 in adults (p less than 0.001). Our findings correlate well with the postnatal microbial colonization of neonatal colon.

The development of colonic transport mechanisms in early life: evidence for reduced anion exchange

An anion exchange mechanism exists in colonic mucosa whereby chloride is absorbed and bicarbonate secreted. Using an in vivo non-equilibrium dialysis method we investigated rectal electrolyte movement in preterm neonates and older children. Our results show that anion exchange is poorly developed in infancy and appears to be absent in premature neonates, and suggest that complete maturation of this mechanism is not present until the end of the first year of life. This may render the young infant, and more especially the preterm infant, more susceptible to chloride depletion.

The influence of ispaghula husk and lactulose on the in vivo and the in vitro production capacity of short-chain fatty acids in humans

To evaluate factors influencing the short-chain fatty acid (SCFA) concentrations in stools, three different experiments were performed: faecal concentrations of SCFA at defecation were determined by gas liquid chromatography in nine healthy volunteers on a free diet. SCFAs were 114 +/- 15.0 mmol/l (means +/- SD). The coefficient of variation (CV) of the assay was 4-15%, the intraindividual CV 12-33%, and the interindividual CV 11-29%. On incubation of faeces at 37 degrees C concentrations of SCFA doubled in 6 h and rose fourfold in 72 h. In three volunteers the experiments were extended by adding ispaghula husk or lactulose to the diet for two 14-day periods each; no change in faecal SCFA concentrations was seen, either at defecation or after incubation. When ispaghula husk or lactulose was added to faeces in an in vitro incubation system, the concentrations of SCFA were five times higher than those of controls. We conclude that instant handling of faeces is essential for determinations of SCFA concentrations to obtain interpretable and comparable results; that determination of total SCFA output is of limited value; that addition of fibre to the diet does not influence faecal SCFA concentrations; and that the capacity for SCFA production in faeces is large provided a sufficient amount of substrate is available.

Occurrence, absorption and metabolism of short chain fatty acids in the digestive tract of mammals

Short chain fatty acids (SCFA) also named volatile fatty acids, mainly acetate, propionate and butyrate, are the major end-products of the microbial digestion of carbohydrates in the alimentary canal. The highest concentrations are observed in the forestomach of the ruminants and in the large intestine (caecum and colon) of all the mammals. Butyrate and caproate released by action of gastric lipase on bovine milk triacylglycerols ingested by preruminants or infants are of nutritional importance too. Both squamous stratified mucosa of rumen and columnar simple epithelium of intestine absorb readily SCFA. The mechanisms of SCFA absorption are incompletely known. Passive diffusion of the unionized form across the cell membrane is currently admitted. In the lumen, the necessary protonation of SCFA anions could come first from the hydration of CO2. The ubiquitous cell membrane process of Na+-H+ exchange can also supply luminal protons. Evidence for an acid microclimate (pH = 5.8-6.8) suitable for SCFA-protonation on the surface of the intestinal lining has been provided recently. This microclimate would be generated by an epithelial secretion of H+ ions and would be protected by the mucus coating from the variable pH of luminal contents. Part of the absorbed SCFA does not reach plasma because it is metabolized in the gastrointestinal wall. Acetate incorporation in mucosal higher lipids is well-known. However, the preponderant metabolic pathway for all the SCFA is catabolism to CO2 except in the rumen wall where about 80% of butyrate is converted to ketone bodies which afterwards flow into bloodstream. Thus, SCFA are an important energy source for the gut mucosa itself.

An experimental design to study colonic fibre fermentation in the rat: the duration of feeding

1. The time-course of metabolic adaptation by rats to diets containing either wheat bran or gum arabic was studied during a 12-week period. 2. Stool weight was increased with wheat bran but not with gum arabic, and had stabilized after 4 weeks. 3. Bacterial mass as measured by diaminopimelic acid content had stabilized by week 4. Bacterial mass increased on feeding gum arabic but was unchanged with wheat bran. 4. There was increased caecal short-chain fatty acid, hydrogen and methane production with gum arabic but not with wheat bran. The change in caecal metabolic activity was slow to stabilize (8-12 weeks at least). 5. The faecal excretion of bile acids increased twofold with the wheat-bran-supplemented diet compared with the gum-arabic-supplemented and unsupplemented diets. Relatively greater amounts of muricholic acids were present in the caeca and faeces of gum-arabic-fed rats compared with the other groups.

The absorptive function of colonic aganglionic intestine: are the Duhamel and Martin procedures rational?

The Lester Martin modification of the Duhamel procedure is an accepted definitive operation for long-segment Hirschsprung's disease, in which considerable use is made of aganglionic bowel. Whether the aganglionic segment contributes to fluid and electrolyte reabsorption is not known. We have modified the technique of nonequilibrium dialysis of the rectum in order to obtain simultaneous measurements of electrolyte transport and transmural potential difference (PD) in 9 infants with Hirschsprung's disease (HD), prior to operation. Six age-matched infants were studied as controls. In the control group Na+ was absorbed electrogenically while K+ secretion was passive and greater than HCO3- secretion. In HD, both NA+ absorption and Cl- absorption were greater than in control children, with Cl- absorption exceeding Na+ absorption. PD was higher in HD infants than in controls, with an associated increase in K+ secretion. HCO3- secretion accounted for the difference between Na+ and Cl- absorption. These data clearly show that aganglionic colon transports electrolytes, and that in the Lester Martin modification of the Duhamel procedure the refashioned colorectum contributes to overall colonic salvage of electrolytes.

[The bacterial fraction in swine feces]

By a treatment with a solution of detergent, subsequent sedimentation and centrifugation faeces samples taken from 12 growing female pigs were divided into: fraction A (coarse particles), fraction B (finer particles), fraction C (bacteria fraction). N-, AA- and diamino pimelic acid (DAP) analyses as well as microscopic analyses were carried out with the complete samples and the fractions. By means of fractioning, 55% of the faecal N and 80% of the DAP could be concentrated in fraction C, fraction A contained approximately 23% of the N and 20% of the DAP. From the DAP: N quotient of fraction C, which was 65 mg DAP/g N, a quota of nearly 70% bacteria-N in the total faecal N of the pigs was calculated.

A comparative study of bicarbonate secretion by ileum and colon of Oryctolagus cuniculus. Influence of caecal pH

The influence of caecal pH on movements of bicarbonate ion in rabbit colon and ileum has been studied. A net secretion of bicarbonate is noted in both intestinal segments (at higher rates in colon than in ileum) in our experimental conditions. The bicarbonate secretion rate is lowered when bicarbonate is added to caecum. The introduction of acetic acid at caecal level increased bicarbonate secretion rate both in ileum as in colon.

Cationophore properties of the new polyether antibiotic Salinomycin investigated in distal rabbit colon in vivo and in vitro

The distal rabbit colon was used as a model to investigate the influence of the cationophore Salinomycin in vivo with a single-pass perfusion, and in vitro with a modified Ussing chamber technique. For in vivo experiments with labelled 14C-PEG as a volume marker in the perfusate, a dose of 10E-4 mol/l Salinomycin was used. Net water (53 microliters/h/cm), net chloride (3 mumol/h/cm) and net sodium (3.6 mumol/h/cm) absorption was not significantly influenced, but net potassium secretion (-3 mumol/h/cm) was decreased to zero and transepithelial potential (PD) reduced from -45 mV to -33 mV. 10E-4 mol/l Salinomycin, applied in vitro on the muscosal side, decreased PD in 80 min and 10E-3 mol/l in 30 min from 18 mV to zero. Both concentrations decreased the short-circuit current (Isc = 77 microA/cm2) in 60 min, respectively 30 min to 40 microA/cm2. After 60 min mucosal 10E-4 mol/l Salinomycin the Isc increased, resulting from a transepithelial conductance (Gt) increase from 3 to 40 mS/cm2. A dose-related effect was present on PD, Isc and Gt at concentrations between 10E-7 and 10E-6 mol/l. The unidirectional 22Na fluxes were increased to 20 times the control values and net Na transport disappeared. We conclude that Salinomycin when applied in usual doses (10E-4 mol/l) as a coccidiostatic feed additive, profoundly affects colonic electrolyte transport.

Active secretion of bicarbonate by rabbit colon

A serosa-mucosa movement of bicarbonate against concentration gradient was detected at this intestinal level. This movement is partially dependent on oxidative phosphorylation since it is abolished by DNP administration, but as it is not affected by acetazolamide administration it can be supposed as dependent on carbonic anhydrase activity.

Evaluation of chloride/bicarbonate. Exchange in the human colon in vivo

During perfusion of a plasma-like solution, colonic absorption rate of chloride was much higher than the secretion rate of bicarbonate (34 vs. 3.5 meq/h, respectively). This might suggest that anion exchange (Cl/HCO3) accounts for only a small fraction of total chloride absorption. However, if the colon absorbs as well as secretes bicarbonate, this reasoning would underestimate the magnitude of the anion exchange. To see if the colon absorbs bicarbonate, we perfused a chloride-free solution (which would eliminate bicarbonate secretion via (Cl/HCO3 exchange) and found that the colon absorbed bicarbonate at a rate of 5.1 meq/h. Calculation of electrochemical gradients and measurement of luminal fluid PCO2 indicated that this bicarbonate absorption was mediated passively in response to electrical gradients, rather than via reversed Cl/HCO3 exchange or acid secretion. The combined results of the plasma-like and chloride-free perfusion experiments suggest Cl/HCO3 exchange at a rate of 8.6 meq/h (the sum of bicarbonate movements, 3.5 and 5.1 meq/h, observed in the two experiments). To obtain a second estimate under different experimental conditions, a choline chloride-choline bicarbonate (sodium-free) solution was perfused; with this solution, chloride and bicarbonate absorption dependent on active sodium transport should be eliminated or markedly reduced, and the magnitude of Cl/HCO3 exchange should be revealed. This experiment suggested a Cl/HCO3 exchange rate of 9.3 meq/h, similar to the first estimate. As chloride was absorbed at a rate of 34 meq/h during perfusion of the plasma-like solution, the Cl/HCO3 exchange provides for approximately one-fourth of total chloride absorption.

A comparative study of electrolyte absorption from the caecum and colon of Oryctolagus cuniculus-I. Chloride and bicarbonate

1. Chloride absorption by the rabbit colon occurs under all the experimental conditions tested, even when intraluminal concentrations are lower than the plasmatic ones. In contrast, at caecal levels, chloride absorption rate depends on the experimental conditions. 2. Bicarbonate is always secreted by the colon even for intraluminal concentrations twice the amount of plasmatic ones. At caecal level, it is absorbed only from concentrations similar to those of the plasma or greater. 3. There seems to be an exchange process affecting chloride and bicarbonate at colonic level but not in the caecum.

Is the rectum usually empty?--A quantitative study in subjects with and without diarrhea

The authors have investigated the frequency with which the rectum contains feces by recording the presence or absence of fecal contamination of the membrane or of discoloration by feces of the contents of dialysis bags placed in the unprepared rectum for one hour. Feces were present in the rectum in 31 per cent of 32 studies in normal control subjects, in 49 per cent of 80 studies in obese subjects (P less than 0.05 from controls), in 36 per cent of 28 studies in patients with the irritable bowel syndrome, and in 31 per cent of 103 studies in patients with ulcerative proctocolitis, whether or not they had diarrhea. Fecal staining of the bag and its contents occurred much more frequently in 27 studies in subjects with various other diarrheal diseases (67 per cent, P less than 0.02 from controls), including eight with steatorrhea (87 per cent, P less than 0.02 from controls). The frequency with which feces were present was unaffected by age, sex, or time of day of the study. These results provide quantitative support for the assertion that in subjects without diarrhea the rectum is usually empty. In patients with diarrhea or steatorrhea and no distal large intestinal inflammation, however, the rectum usually does contain fecal material.

The role of acetylcholine in the regulation of ion transport by rat colon mucosa

1. Acetylcholine increases the potential difference across rat proximal colon both in vivo and in vitro.2. There is a sigmoid relationship between the change in potential difference and the logarithm of the dose of acetylcholine. The dose-response curve is shifted to the left by neostigmine and to the right by atropine, suggesting that the action of acetylcholine is mediated by a muscarinic type of receptor.3. The dose-response curve for acetylcholine in vivo is not altered by the ganglion-blocking agents hexamethonium and pentolinium, suggesting a direct effect of this transmitter on the colon.4. Acetylcholine causes an increase in potential difference, a small decrease in resistance and hence a rise in the current generated by both normal and stripped everted sacs of rat colon.5. In the absence of sodium, the calculated current change produced by acetylcholine is reduced, and the removal of chloride has a similar inhibitory effect. The absence of bicarbonate does not significantly affect the response.6. Acetylcholine virtually abolished net sodium movement and induced net chloride secretion and these changes accounted for the increased short-circuit current.7. Acetylcholine had no effect on oxygen consumption by rings of colon.8. Tracts staining for acetylcholinesterase were observed running from the submucous plexus towards the mucosal epithelium.9. This study shows that acetylcholine can influence ion movement by rat colonic mucosa and suggests that the autonomic nervous system might be involved in the regulation of transport mechanisms in this tissue.

Absorption of horseradish peroxidase by the principal cells of the large intestines of postnatal developing rats

The absorption of horseradish peroxidase in the rat large intestine during the postnatal developing period was investigated by cytochemical and ultrastructural methods. In the ceca and ascending colons from 4-, and 5-day-old rats, intraluminaly injected peroxidase became localised on microvilli, in the intracytoplasmic network of the apical tubules and small vacuoles (tubulo-vacuolar system), in the large supranuclear vacuole, in the Golgi apparatus, on the lateral and basal cell membranes of the surface principal cells, and also in the lumen of blood capillaries in the subjacent propria. On the other hand, the protein tracer was not seen in the large intestinal epithelial cells that lack tubulo-vacuolar systems and large supranuclear vacuoles within their cytoplasm. In the descending colons of rats of any postnatal age, the epithelial principal cells are devoid of these membrane systems, and exogenous peroxidase was not detected in the cytoplasm of the principal cells. It is assumed that at least the proximal portion of the large intestine in neonatal animals has the capacity to absorb macromolecular protein through those surface principal cells that have specialized intracellular membrane systems.