Changes in mucosal nutrient transport in small and large ileal reservoirs after endorectal ileal pullthrough

Matthias Stelzner, Randal Buddington, J. Duncan Phillips, Jared M. Diamond, Eric W. Fonkalsrud

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

It has been hypothesized that, following colectomy and endorectal ileal pullthrough with ileal reservoir (PTR), reservoir tissue might lose some of its normal nutrient transport capacity and assume properties of the colon. Whether reservoir size influences the expected alterations in normal mucosal absorption and thus contributes to changes in intraluminal ecology has not previously been investigated. To study this, the everted intestinal sleeve technique was used to measure uptake of four nutrients in two groups of dogs who underwent PTR: five with a small (5 cm) lateral reservoir and five with a large (18 cm) reservoir. Mucosal samples were taken from normal ileum and colon and from reservoirs 3 months postoperation. Active uptake of carbohydrates (glucose), amino acids (proline), and bile acids (taurocholate) and passive uptake of short chain fatty acids (propionate) were markedly decreased in mucosa of both reservoir sizes compared to normal ileum (P < 0.05, t test) and more closely approximated that of normal colon. Uptake of glucose, proline, and taurocholate in large reservoirs was significantly less than that in small reservoirs (P < 0.05). We conclude that (1) ileal reservoir mucosa has a significantly reduced capacity for nutrient uptake, (2) ileal mucosa in small reservoirs shows higher nutrient uptake rates than mucosa in large reservoirs, and (3) short, well-emptying reservoirs appear best suited to optimizing the intraluminal environment and thus enhance reservoir function when performing PTR.

Original languageEnglish (US)
Pages (from-to)344-349
Number of pages6
JournalJournal of Surgical Research
Volume49
Issue number4
DOIs
StatePublished - Jan 1 1990
Externally publishedYes

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Colonic Pouches
Mucous Membrane
Food
Taurocholic Acid
Colon
Ileum
Proline
Glucose
Colectomy
Volatile Fatty Acids
Propionates
Ecology
Bile Acids and Salts
Carbohydrates
Dogs
Amino Acids

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Changes in mucosal nutrient transport in small and large ileal reservoirs after endorectal ileal pullthrough. / Stelzner, Matthias; Buddington, Randal; Phillips, J. Duncan; Diamond, Jared M.; Fonkalsrud, Eric W.

In: Journal of Surgical Research, Vol. 49, No. 4, 01.01.1990, p. 344-349.

Research output: Contribution to journalArticle

Stelzner, Matthias ; Buddington, Randal ; Phillips, J. Duncan ; Diamond, Jared M. ; Fonkalsrud, Eric W. / Changes in mucosal nutrient transport in small and large ileal reservoirs after endorectal ileal pullthrough. In: Journal of Surgical Research. 1990 ; Vol. 49, No. 4. pp. 344-349.
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