Briet F, Flourié B, Achour L, Maurel M, Rambaud J C, Messing B
INSERM Unité 290, Hôpital Saint-Lazare, Paris, France.
Gastroenterology. 1995 Nov;109(5):1446-53. doi: 10.1016/0016-5085(95)90629-0.
BACKGROUND & AIMS: Long-term carbohydrate malabsorption in patients with short bowel and colon in continuity (SBC) could result in a more efficient fermentation. The bacterial fermentation capacity in patients with SBC was assessed.
Eleven fasting patients with SBC ingested 60 g lactulose with 10 g polyethylene glycol. Stool specimens were analyzed. Patients were compared with 8 normal subjects who ingested 60 g lactulose on two occasions, separated by 8 days during which 20 g lactulose was taken twice daily. Moreover, the daily amount of bacteria excreted in stools was measured in 6 patients with SBC and 6 normal subjects.
Despite fast transit time, patients fermented more lactulose and hexoses and had a higher activity of beta-galactosidase in stools than nonadapted normal subjects (P < 0.01); these parameters were roughly similar in patients and adapted normal subjects. The fecal output of short-chain fatty acids was significantly lower in patients than in nonadapted normal subjects (P < 0.03). Patients excreted a significantly greater amount of bacteria in stools than normal subjects (P < 0.05).
In patients with SBC, the capacity of bacterial flora to ferment lactulose and fecal bacterial mass is spontaneously increased, suggesting that hyperfermentation may affect other carbohydrates. Moreover, hyperfermentation is associated with efficient removal of extra short-chain fatty acids from fecal water.
短肠并结肠连续存在（SBC）患者的长期碳水化合物吸收不良可能导致更有效的发酵。对SBC患者的细菌发酵能力进行了评估。
11例禁食的SBC患者摄入含10 g聚乙二醇的60 g乳果糖。对粪便标本进行分析。将患者与8名正常受试者进行比较，后者分两次摄入60 g乳果糖，两次间隔8天，在此期间每天服用2次20 g乳果糖。此外，还对6例SBC患者和6名正常受试者粪便中每日排出的细菌量进行了测量。
尽管转运时间快，但与未适应的正常受试者相比，患者发酵的乳果糖和己糖更多，粪便中β-半乳糖苷酶活性更高（P < 0.01）；这些参数在患者和适应的正常受试者中大致相似。患者粪便中短链脂肪酸的排出量明显低于未适应的正常受试者（P < 0.03）。患者粪便中排出的细菌量明显多于正常受试者（P < 0.05）。
在SBC患者中，肠道菌群发酵乳果糖的能力和粪便细菌量会自发增加，这表明过度发酵可能会影响其他碳水化合物。此外，过度发酵与从粪便水中有效清除多余的短链脂肪酸有关。
