Functional adaptation of the intestinal mucosal enzymes after jejunoileal bypass for morbid obesity.

Functional adaptation of the villus brush border and crypt have been evaluated preceding and following jejunoileal bypass for morbid obesity. Before surgery, 26 of 101 patients who were at least 100% above their ideal weight were randomly included into the study group, and control tissue specimens were collected from the jejunum and ileum. When five patients required revision of the bypass, jejunal and ileal specimens were collected from the functional (included) and nonfunctional (excluded) segments. At 19.2 +/- 5.0 (SD) months following the bypass procedure, there was an increase in alkaline phosphatase, sucrase and thymidine kinase specific activities within the functional remnants; the included ileum demonstrated a greater degree of adaptation than the included jejunum. In the nonfunctional jejunum there was a decrease in alkaline phosphatase and thymidine kinase specific activities, whereas no statistical alteration in mucosal enzyme activities occurred within the nonfunctional ileum. Serum total protein concentrations and serum magnesium levels were also evaluated before bypass and at revision. Mean serum magnesium levels became decreased, whereas serum total protein concentrations were not altered.