title: Gastrointestinal transit, appetite, and energy balance in gastrectomized patients.
abstract: BACKGROUND
  Alterations in gastrointestinal tract physiology after gastrectomy may affect appetite and energy balance.
  
  
  OBJECTIVE
  The objective of this study was to examine energy balance, appetite, and gastrointestinal transit in subjects with gastrectomy.
  
  
  METHODS
  Seven subjects with total gastrectomy (TG) and 14 subjects with partial gastrectomy (PG), who were free from signs of recurrent disease, and 10 healthy control subjects were studied. Resting energy expenditure (REE) was measured by indirect calorimetry and compared with REE predicted by the Harris-Benedict equation (mREE/pREE%). Gastrointestinal transit was measured by scintigraphy. Habitual food intake was assessed, and appetite was measured during scintigraphy after ingestion of a test meal (361 kcal).
  
  
  RESULTS
  Body mass index was not different among the groups. mREE/pREE% was higher in patients with PG (P < 0.01) than in control subjects. The TG group showed higher energy intake (P < 0.05) than the PG group and control subjects. Gastric emptying was faster in the PG group than in control subjects, and gastrointestinal transit was accelerated in both PG and TG groups. An intense, precocious postprandial fullness and a relatively early recovery of hunger and prospective consumption sensations were seen in these patients.
  
  
  CONCLUSIONS
  Patients with PG or TG have higher than predicted energy expenditure, which in TG seems to be compensated for by increased energy intake. These patients have preserved postprandial appetite responses and precocious postprandial fullness, which seem to be associated with disturbances in gastrointestinal transit of the ingested meal and are likely to be independent of vagal fiber integrity or stomach-released ghrelin.
authors.affiliation: Department of Medicine, Faculty of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil. maykamiji@hotmail.com
authors.forename: Mayra M
authors.initials: MM
authors.lastname: Kamiji
authors.forename: Luiz E A
authors.initials: LE
authors.lastname: Troncon
authors.forename: Vivian M M
authors.initials: VM
authors.lastname: Suen
authors.forename: Ricardo B
authors.initials: RB
authors.lastname: de Oliveira
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001066:Appetite / Q000502:physiology*; D001481:Basal Metabolism / Q000502:physiology*; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D016022:Case-Control Studies; D002149:Energy Intake / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D005743:Gastrectomy; D005746:Gastric Emptying / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery; D013276:Stomach Ulcer / Q000601:surgery