Royall D, Wolever T M, Jeejeebhoy K N
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Canada.
Am J Gastroenterol. 1992 Jun;87(6):751-6.
The purpose of this study was to determine whether energy from malabsorbed carbohydrate could be conserved through colonic fermentation in short bowel syndrome. Seven patients with short bowel anastomosed to the remaining colon and five patients with short bowel without a colon were selected from the home total parenteral nutrition (TPN) program. Six normal volunteers also were studied. After an overnight fast, subjects consumed a 50-g carbohydrate bread meal and were studied hourly over the next 6 h. Carbohydrate malabsorption, estimated by lactulose breath hydrogen testing, was 48 +/- 13% in short bowel patients. After the bread meal, breath hydrogen was higher in short bowels with colons (69 +/- 20 ppm) than in either short bowels without colons (11 +/- 7 ppm) or normal subjects (10 +/- 3 ppm) (p less than 0.01). Blood acetate levels also were higher in short bowels with colons than in those without colons, reaching a peak of 167 +/- 27 mumol/L at 4 h (p less than 0.05). We conclude that in patients with a short bowel and a colon, malabsorbed carbohydrate is fermented and there is a rise in blood acetate, suggesting that the colon has a role in salvaging malabsorbed carbohydrate as a source of energy through carbohydrate fermentation.
本研究的目的是确定短肠综合征患者是否可通过结肠发酵来保存未被吸收的碳水化合物中的能量。从家庭全胃肠外营养（TPN）项目中选取了7例短肠与剩余结肠吻合的患者以及5例无结肠的短肠患者。还研究了6名正常志愿者。经过一夜禁食后，受试者食用了一顿含50克碳水化合物的面包餐，并在接下来的6小时内每小时进行一次研究。通过乳果糖呼气氢试验估计，短肠患者的碳水化合物吸收不良率为48±13%。食用面包餐后，有结肠的短肠患者的呼气氢含量（69±20 ppm）高于无结肠的短肠患者（11±7 ppm）或正常受试者（10±3 ppm）（p<0.01）。有结肠的短肠患者的血乙酸水平也高于无结肠的短肠患者，在4小时时达到峰值167±27 μmol/L（p<0.05）。我们得出结论，在有短肠和结肠的患者中，未被吸收的碳水化合物会发酵，血乙酸水平会升高，这表明结肠在通过碳水化合物发酵挽救未被吸收的碳水化合物作为能量来源方面发挥了作用。
