title: Lactulose feeding lowers cecal densities of clostridia in piglets.
abstract: BACKGROUND
  In order to understand the consequences of persistent enteral feeding in patients with carbohydrate malabsorption, we fed piglets lactulose in sufficient dosage to produce osmotic diarrhea or inulin, using a conventional dose, to determine if this prebiotic can modulate the effects of lactulose. Feeding lactulose increases cecal luminal synthesis of butyrate, with inulin having an intermediate effect. Because clostridia may be a major source of colonic butyrate production, we hypothesized that feeding piglets lactulose or inulin would increase cecal densities of clostridia.
  
  
  METHODS
  Piglets were assigned to 3 formula study groups for 6 days: (1) control, fed only sow milk replacer (n = 12); (2) inulin, inulin supplement (3 g/L; n = 11); and (3) lactulose, lactulose supplement (66.7 g/L; n = 6). Cecal fluid for bacteriological studies was sampled intraoperatively.
  
  
  RESULTS
  The wet/dry ratio of the cecal contents (mean +/- SEM) was 8.2 +/- 0.5, 6.2 +/- 0.5, and 18.8 +/- 5.5, respectively, in the control, inulin, and lactulose groups (p = .049, Kruskal-Wallis). There were no differences among the diet groups for cecal densities (10(6) colony-forming units [CFU]/g dry wt cecal contents) of total anaerobes, total aerobes, bifidobacteria, or lactobacilli. Densities of clostridia were markedly reduced in the lactulose group (1.14 +/- 0.41) vs the control (18.39 +/- 4.44; p = .001) or inulin groups (8.87 +/- 2.20; p = .04).
  
  
  CONCLUSIONS
  In piglets, feeding lactulose at a dose known to cause diarrhea reduces cecal densities of clostridia.
authors.affiliation: Department of Pediatrics, College of Medicine, University of Vermont, Burlington, Vermont, USA. cl.kien@uvm.edu
authors.forename: C Lawrence
authors.initials: CL
authors.lastname: Kien
authors.forename: Ruth
authors.initials: R
authors.lastname: Blauwiekel
authors.forename: Carol H
authors.initials: CH
authors.lastname: Williams
authors.forename: Janice Yanushka
authors.initials: JY
authors.lastname: Bunn
authors.forename: Randal K
authors.initials: RK
authors.lastname: Buddington
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D002087:Butyrates / Q000378:metabolism; D002432:Cecum / Q000382:microbiology*; D003013:Clostridium / Q000187:drug effects* / Q000254:growth & development / Q000378:metabolism; D015169:Colony Count, Microbial; D003967:Diarrhea / Q000139:chemically induced / Q000517:prevention & control; D004750:Enteral Nutrition / Q000009:adverse effects; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D007444:Inulin / Q000494:pharmacology; D007792:Lactulose / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D008286:Malabsorption Syndromes / Q000139:chemically induced / Q000517:prevention & control; D009929:Organ Size / Q000187:drug effects; D019936:Probiotics; D011897:Random Allocation; D018709:Statistics, Nonparametric; D013552:Swine
chemical_list: D002087:Butyrates; D005765:Gastrointestinal Agents; D007792:Lactulose; D007444:Inulin