title: Resection of the large bowel suppresses hunger and food intake and modulates gastrointestinal fermentation.
abstract: To assess appetite and gut hormone levels in patients following partial (PR) or total resection (TR) of the large bowel.
  
  
  
  A comparative cross sectional study was carried out with healthy controls (n = 99) and patients who had undergone PR (n = 64) or TR (n = 12) of the large bowel. Participants consumed a standard (720 kcal) breakfast meal at 0830 (t = 0) h followed by lactulose (15 g) and a buffet lunch (t = 210 min). Participants rated the subjective feelings of hunger at t = -30, 0, 30, 60, 120, and 180 min. Breath hydrogen (BH) concentrations were also evaluated. In a matched subset (11 controls, 11 PR and 9 TR patients) PYY and GLP-1 concentrations were measured following breakfast. The primary outcome measure was appetite, as measured using visual analogue scales and the buffet lunch. The secondary outcome was BH concentrations following a test meal.
  
  
  
  PR and TR participants had lower hunger and energy intake at the buffet lunch meal compared to controls. PR subjects had higher BH concentrations compared to controls and TR subjects. BH levels correlated with circulating GLP-1 levels at specific time points.
  
  
  
  PR or TR of the large bowel reduced feelings of hunger and energy intake, and PR increased gastrointestinal fermentation.
authors.affiliation: Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
authors.forename: Priyadarshika
authors.initials: P
authors.lastname: Hettiarachchi
authors.affiliation: Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
authors.forename: A Rajitha
authors.initials: AR
authors.lastname: Wickremasinghe
authors.affiliation: Nutrition and Dietetic Research Group, Department of Medicine, Imperial College, London, UK.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Frost
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
authors.forename: Kemal I
authors.initials: KI
authors.lastname: Deen
authors.affiliation: Department of Surgery, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
authors.forename: Ajith A
authors.initials: AA
authors.lastname: Pathirana
authors.affiliation: Section of Investigative Medicine, Department of Medicine, Imperial College, London, UK.
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Murphy
authors.affiliation: Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
authors.forename: SriLal D
authors.initials: SD
authors.lastname: Jayaratne
mesh_terms: D000328:Adult; D001066:Appetite; D062408:Breakfast; D003430:Cross-Sectional Studies; D004435:Eating; D002149:Energy Intake; D005260:Female; D005743:Gastrectomy; D005749:Gastric Inhibitory Polypeptide / Q000378:metabolism; D005768:Gastrointestinal Hormones / Q000378:metabolism*; D006801:Humans; D006815:Hunger; D007421:Intestine, Small / Q000378:metabolism* / Q000601:surgery*; D062409:Lunch; D008297:Male; D009765:Obesity / Q000601:surgery
chemical_list: D005768:Gastrointestinal Hormones; D005749:Gastric Inhibitory Polypeptide