Metabolic adaptation of terminal ileal mucosa after construction of an ileoanal pouch.
BACKGROUND
The major nutrients for the large bowel and small bowel mucosa are, respectively, butyrate and glutamine. The degree of mucosal adaptation that may occur in response to changes in nutrient supply and faecal stasis after the formation of an ileoanal pouch is poorly understood.


METHODS
The ability of ileal mucosal biopsies, from nine patients with ulcerative colitis and from 18 with an ileoanal pouch, to oxidize [14C]-glucose, glutamine and butyrate to carbon dioxide was quantified.


RESULTS
Glucose, glutamine and butyrate were oxidized respectively at a median of 12.5 (95 per cent confidence interval (4-22), 77 (34-207) and 194 (81-321) pmol microgram-1 h-1 by ileal mucosa and 12.9 (6-21), 35 (11-57) and 194 (73-737) pmol microgram-1 h-1 by pouch mucosa.


CONCLUSIONS
Ileoanal pouch construction and subsequent bacterial colonization and faecal stasis resulted in a significant (P < 0.05) reduction in the mucosal ability to oxidize glutamine whereas there was no difference in the rate of butyrate oxidation.
Chapman
M A
MA
Department of Surgery, London Hospital Medical School, UK.
Hutton
M
M
Grahn
M F
MF
Williams
N S
NS
D000328:Adult; D000368:Aged; D002087:Butyrates / Q000378:metabolism*; D020148:Butyric Acid; D003093:Colitis, Ulcerative / Q000378:metabolism* / Q000601:surgery; D005260:Female; D005947:Glucose / Q000378:metabolism*; D005973:Glutamine / Q000378:metabolism*; D006801:Humans; D007082:Ileum / Q000378:metabolism*; D007413:Intestinal Mucosa; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D016737:Proctocolectomy, Restorative
D002087:Butyrates; D005973:Glutamine; D020148:Butyric Acid; D005947:Glucose