title: Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome.
abstract: OBJECTIVE
  Colostrum is rich in immunoregulatory, antimicrobial and trophic components supporting intestinal development and function in newborns. We assessed whether bovine colostrum could enhance intestinal adaptation and function in adult short bowel syndrome (SBS) patients.
  
  
  METHODS
  Twelve SBS patients in this randomised cross-over study received 4 weeks oral supplement of bovine colostrum or an iso-energetic and iso-proteinaceous control (2.4 MJ/d, 500 ml/day) separated by a 4-week washout period. Patients were admitted four times for 72-h periods of fluid, electrolyte and nutrient balance studies. Meals, faeces and urine were weighed, and energy, macronutrient and electrolyte contents were analysed to calculate net nutrient uptake. Body composition was measured by dual-energy X-ray absorptiometry scans, and functional tests of handgrip strength and lung functions were performed. Eight patients completed the study and were included in the analysis.
  
  
  RESULTS
  Both supplements (colostrum and control) not only increased protein (0.96 ± 0.42 MJ/d, P=0.004 1.03 ± 0.44 MJ/d, P=0.003) and energy (1.46 ± 1.02 MJ/d, P=0.005, 1.76 ± 1.46 MJ/d, P=0.01) absorption but also absolute faecal wet weight excretions (231 ± 248 g/d, P=0.002, 319 ± 299 g/d, P=0.03), compared with baseline measurements. Both supplements improved handgrip strength (P=0.03) while only the control supplement increased lean body mass (1.12 ± 1.33 kg, P<0.049). Colostrum was not found to be superior to the control.
  
  
  CONCLUSIONS
  Intake of high-protein milk supplements increased net nutrient absorption for adult SBS patients, but at the expense of increased diarrhoea. Despite high contents of bioactive factors, colostrum did not significantly improve intestinal absorption, body composition or functional tests compared with the control.
authors: Department of Gastroenterology CA-2121, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. pernillelund@dadlnet.dk
authors: P
authors: P
authors: Lund
authors: P T
authors: PT
authors: Sangild
authors: L
authors: L
authors: Aunsholt
authors: B
authors: B
authors: Hartmann
authors: J J
authors: JJ
authors: Holst
authors: J
authors: J
authors: Mortensen
authors: P B
authors: PB
authors: Mortensen
authors: P B
authors: PB
authors: Jeppesen
mesh_terms: D000818:Animals; D001481:Basal Metabolism; D001823:Body Composition; D002417:Cattle; D003126:Colostrum; D018592:Cross-Over Studies; D004311:Double-Blind Method; D002149:Energy Intake; D005243:Feces / Q000737:chemistry; D005260:Female; D018737:Hand Strength; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012778:Short Bowel Syndrome / Q000378:metabolism / Q000628:therapy*