Extensive Intestinal Resection Triggers Behavioral Adaptation, Intestinal Remodeling and Microbiota Transition in Short Bowel Syndrome.
Extensive resection of small bowel often leads to short bowel syndrome (SBS). SBS patients develop clinical mal-absorption and dehydration relative to the reduction of absorptive area, acceleration of gastrointestinal transit time and modifications of the gastrointestinal intra-luminal environment. As a consequence of severe mal-absorption, patients require parenteral nutrition (PN). In adults, the overall adaptation following intestinal resection includes spontaneous and complex compensatory processes such as hyperphagia, mucosal remodeling of the remaining part of the intestine and major modifications of the microbiota. SBS patients, with colon in continuity, harbor a specific fecal microbiota that we called "lactobiota" because it is enriched in the Lactobacillus/Leuconostoc group and depleted in anaerobic micro-organisms (especially Clostridium and Bacteroides). In some patients, the lactobiota-driven fermentative activities lead to an accumulation of fecal d/l-lactates and an increased risk of d-encephalopathy. Better knowledge of clinical parameters and lactobiota characteristics has made it possible to stratify patients and define group at risk for d-encephalopathy crises.
Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France. camille.mayeur@jouy.inra.fr.
Camille
C
Mayeur
Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unit, APHP, F-75890 Paris, France. gillard.laura@yahoo.com.
Laura
L
Gillard
Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unit, APHP, F-75890 Paris, France. johanne.le-beyec@inserm.fr.|Université Pierre et Marie Curie and Department of Endocrine and Oncologic Biochemistry, APHP La Pitié-Salpêtrière Hospital,73013 Paris, France. johanne.le-beyec@inserm.fr.
Johanne
J
Le Beyec
Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unit, APHP, F-75890 Paris, France. johanne.le-beyec@inserm.fr.
André
A
Bado
Inserm UMR 1149, UFR de Médecine Paris Diderot, Université Paris Diderot, Sorbonne Paris Cité, DHU Unit, APHP, F-75890 Paris, France. francisca.joly@aphp.fr.|Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France. francisca.joly@aphp.fr.
Francisca
F
Joly
Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France. muriel.thomas@jouy.inra.fr.
Muriel
M
Thomas
colon; dysbiosis; lactate; mal-absorption; surgery
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