Sclafani A
Department of Psychology, Brooklyn College of the City University of New York.
Gastroenterol Clin North Am. 1987 Sep;16(3):461-77.
Surgical manipulations of the gastrointestinal system can have a major impact on the ingestive behavior of animals. Particularly well-documented are the feeding and drinking effects of JIB and vagotomy. These two surgical procedures are similar in that they reduce the food intake and body weight of obese animals more than that of lean animals, and of hypothalamic obese rats more than that of genetically obese rats. Intermediate effects are obtained with other obesity models. Given the multiple etiologies of human obesity, it is not surprising that gastrointestinal surgery has variable effects in obese humans. The effects of gastric surgery on the ingestive behavior of animals have received relatively little attention. This is unfortunate because gastric bypass is now one of the most widely used methods for surgical treatment of human obesity. In light of recent developments in gastric surgical techniques and new findings concerning the gastric modulation of food intake, the effects of gastric surgery on the feeding behavior of animals should be further investigated. Much remains to be learned about the physiologic and behavioral mechanisms by which gastrointestinal surgery influences ingestive behavior and body weight. Surgical manipulations of the gastrointestinal system may affect ingestive behavior by directly altering the neural and hormonal feedback signals to the brain from the stomach, intestines, and other organs (liver, pancreas), or they may indirectly alter these feedback signals by modifying the preabsorptive and/or postabsorptive flow of nutrients. Seen from a functional perspective, the gut sends to the brain different types of messages that modulate ingestive behavior. Most attention has focused on gut satiety signals, but the gut can also be the source of painful sensations that suppress ingestive behavior. The distinction between satiety and discomfort is not always clear-cut. For example, gut distention may be satiating when it is moderate, but painful when it is extreme. Nevertheless, the distinction is an important one, and the nature of the feeding-inhibitory effects obtained in animal studies must be carefully evaluated. Ideally, obesity surgery should produce minimal aversive consequences, although whether it is possible to reduce food intake and body weight without producing any discomfort remains to be established. In addition to being a source of feeding-inhibitory cues, the gastrointestinal system may also provide excitatory cues that stimulate feeding and modify food preferences. For example, intestinal infusions of carbohydrates increase subsequent food intake under certain conditions.(ABSTRACT TRUNCATED AT 400 WORDS)
胃肠道系统的外科手术操作会对动物的摄食行为产生重大影响。尤其是空肠回肠旁路术(JIB)和迷走神经切断术对摄食和饮水的影响已有充分记录。这两种外科手术的相似之处在于,相较于瘦动物,它们对肥胖动物食物摄入量和体重的降低幅度更大;相较于遗传性肥胖大鼠,对下丘脑性肥胖大鼠的影响更明显。在其他肥胖模型中则会产生中等程度的影响。鉴于人类肥胖存在多种病因,胃肠道手术对肥胖人类产生不同影响也就不足为奇了。胃手术对动物摄食行为的影响相对较少受到关注。这很遗憾,因为胃旁路术目前是治疗人类肥胖最广泛使用的外科方法之一。鉴于胃外科技术的最新进展以及关于胃对食物摄入量调节的新发现,胃手术对动物摄食行为的影响应进一步研究。关于胃肠道手术影响摄食行为和体重的生理及行为机制,仍有许多有待了解之处。胃肠道系统的外科手术操作可能通过直接改变来自胃、肠及其他器官(肝脏、胰腺)向大脑传递的神经和激素反馈信号来影响摄食行为,或者通过改变营养物质吸收前和/或吸收后的流动间接改变这些反馈信号。从功能角度看,肠道向大脑发送不同类型的信息来调节摄食行为。大多数注意力集中在肠道饱腹感信号上,但肠道也可能是抑制摄食行为的疼痛感觉的来源。饱腹感和不适感之间的区别并不总是清晰的。例如,肠道适度扩张可能产生饱腹感,但极度扩张则会引起疼痛。然而,这种区别很重要,必须仔细评估在动物研究中获得的抑制摄食作用的性质。理想情况下,肥胖症手术应产生最小的不良后果,尽管是否有可能在不产生任何不适的情况下减少食物摄入量和体重仍有待确定。除了作为抑制摄食线索的来源外,胃肠道系统还可能提供刺激摄食和改变食物偏好的兴奋性线索。例如,在某些条件下,肠道输注碳水化合物会增加随后的食物摄入量。(摘要截选至400字)