Effect of glutamine in short-bowel syndrome.
OBJECTIVE
Animal studies have reported positive effects of glutamine on intestinal absorption and morphology; human studies have been less convincing. The aim of this study was to evaluate the effects of glutamine and diet on intestinal morphology, motility, and absorption.


METHODS
A randomized, double blind, placebo-controlled crossover study in 8 patients with short-bowel on a high carbohydrate, low fat (HCLF) diet, was performed. Active treatment was oral glutamine (0.45 g kg(-1)day(-1)) for eight weeks. Intestinal morphology was evaluated by light microscopy. Gastrointestinal transit was measured by dual gamma camera scintigraphy. D-xylose and fecal fat collection was used to evaluate intestinal absorption. Results of active treatment versus placebo were compared by the signed-rank test.


RESULTS
Morphology analysis, reported as median active treatment versus placebo, was villus height: 0.48 mm versus 0.50 mm, P=1.0, and crypt depth: 0.11 mm versus 0.10 mm, P=0.469. Percent D-xylose absorption, reported as median active treatment versus placebo, was 7% versus 10.5%, P=0.109. There was not a significant difference in wet weight or fat absorption compared to placebo, P>0.05. Likewise, gastrointestinal transit was not different compared to placebo.


CONCLUSIONS
The results of this controlled study would support that 8 weeks of treatment with oral glutamine and a HCLF diet does not significantly improve intestinal morphology, gastrointestinal transit, D-xylose absorption and stool losses in short bowel patients.
Scolapio
J S
JS
Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, Florida 32224, USA.
McGreevy
K
K
Tennyson
G S
GS
Burnett
O L
OL
D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D005243:Feces / Q000737:chemistry; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D005772:Gastrointestinal Transit; D005973:Glutamine / Q000494:pharmacology*; D006801:Humans; D007408:Intestinal Absorption / Q000187:drug effects*; D007422:Intestines / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012778:Short Bowel Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D014994:Xylose / Q000493:pharmacokinetics*
D005973:Glutamine; D014994:Xylose