Improvement Of Intestinal Function Research Articles

Ameliorative Effects of Zingiber officinale Rosc on Antibiotic-Associated Diarrhea and Improvement in Intestinal Function.

The global increase in antibiotic consumption is related to increased adverse effects, such as antibiotic-associated diarrhea (AAD). This study investigated the chemical properties of Zingiber officinale Rosc (ZO) extract and its ameliorative effects using a lincomycin-induced AAD mouse model. Intestinal tissues were evaluated for the expression of lysozyme, claudin-1, and α-defensin-1, which are associated with intestinal homeostasis. The cecum was analyzed to assess the concentration of short-chain fatty acids (SCFAs). The chemical properties analysis of ZO extracts revealed the levels of total neutral sugars, acidic sugars, proteins, and polyphenols to be 86.4%, 8.8%, 4.0%, and 0.8%, respectively. Furthermore, the monosaccharide composition of ZO was determined to include glucose (97.3%) and galactose (2.7%). ZO extract administration ameliorated the impact of AAD and associated weight loss, and water intake also returned to normal. Moreover, treatment with ZO extract restored the expression levels of lysozyme, α-defensin-1, and claudin-1 to normal levels. The decreased SCFA levels due to induced AAD showed a return to normal levels. The results indicate that ZO extract improved AAD, strengthened the intestinal barrier, and normalized SCFA levels, showing that ZO extract possesses intestinal-function strengthening effects.

Fermented soybean meal increases nutrient digestibility via the improvement of intestinal function, anti-oxidative capacity and immune function of weaned pigs

The nutritional components of fermented soybean meal (FSBM) vary because of the complex process of microbial fermentation. The objective of this study was to investigate the nutritional value of FSBM from two sources and explore the mode of actions of FSBM on the improvement of nutrient digestibility with the measurements of digestive enzymes and serum biomarkers. Eight weaned barrows (initial BW: 14.12 ± 0.24 kg) equipped with T-cannula in the distal ileum were allotted to a duplicated 4 × 4 Latin-square design with four experimental diets and four periods. Four experimental diets included a soybean meal control diet, two FSBM diets, and a nitrogen-free diet. The two sources of FSBM increased the contents of CP, amino acid and lactic acid, while decreased the levels of anti-nutritional factors, including glycinin, β-conglycinin and trypsin inhibitors. Compared to soybean meal control diet, both FSBM diets significantly increased the apparent and standardised ileal digestibility of CP and amino acids (P < 0.05), increased the activities of lipase, maltase and invertase in digesta (P < 0.05), increased total antioxidant capacity, activities of glutathione peroxidase and superoxide dismutase, the levels of interleukin-4, IgA, IgG and IgM in serum (P < 0.05), while decreased the levels of diamine oxidase, malondialdehyde, interleukin-6, and interleukin-2 in serum (P < 0.05). Additionally, the standardised ileal digestibility of amino acids were highly correlated with the aforementioned digestive enzymes and health-related serum biomarkers. In summary, FSBM diets showed an improved nutritional value evidenced by the higher nutrient digestibility, which may be partially derived from its beneficial effects on intestinal integrity, anti-oxidative capacity and immune function.

Nutritional digestion and absorption, metabolism fates alteration was associated with intestinal function improvement by dietary threonine in juvenile grass carp (Ctenopharyngodon Idella)

This study was designed to examine the effects of threonine (Thr) on digestion and absorption, serum biochemical parameters, genes expression of Thr metabolism related enzymes and intestinal mucins as well as potential regulation in juveniles grass carp (Ctenopharyngodon idella). Juveniles (9.53 ± 0.02 g) were reared for eight weeks with graded Thr levels (3.99, 7.70, 10.72, 14.10, 17.96 and 21.66 g/kg). Results showed that, comparing with Thr-insufficient diet (3.99 g/kg), optimal dietary Thr group (14.10 g/kg) significantly (P < 0.05) increased the digestive enzymes (trypsin, lipase and amylase) in the hepatopancreas and intestine, absorptive related enzymes Na+, K+-ATPase (NKA), alkaline phosphatase (AKP), creatine kinase (CK) and gamma-glutamyl transpeptidase (γ-GT) in intestines and contents of total protein (TP), albumin (ALB) and globulin (GLB) in the serum of juvenile grass carp. The notable decreases of serum total cholesterol (TC) content and activities of aspartate transaminase (AST) as well as alanine transaminase (ALT) were observed in juveniles fed 14.10 g/kg Thr diet (P < 0.05). Moreover, L-threonine dehydrogenase (tdh) was the main responsible for Thr catabolism enzyme with highly expressed in the hepatopancreas, which could be upregulated by increment dietary Thr in both hepatopancreas and intestines significantly (P < 0.05); L-threonine ammonia-lyase (thal) mRNA abundance was upregulated by dietary Thr in the hepatopancreas but not intestines; L-threonine aldolase (tha) mRNA abundance was not affected by dietary Thr in hepatopancreas and intestines (P > 0.05). Besides, the optimal Thr level promoted intestinal mucin synthesis involved enzyme N-acetyl-galactosaminyltransferase 2 (galnt2), mucin2 (muc-2) and muc-3 mRNA transcript abundances as well as phosphorylated protein levels of epidermal growth factor receptor (EGFR) (Tyr992), extracellular regulating kinase 1/2 (ERK1/2) (Thr202/Tyr204) and transcription factor SP1 (Thr453), thus enhancing the intestinal function. Additionally, the optimal dietary Thr could reverse the intestinal villus morphology structure destroyed with villus twist and exfoliation by dietary Thr deficiency as well as fusion by excess level of dietary Thr, which was in accordance with the improvement of intestinal function.

Effect on the Improvement of Intestinal Function and Constipation of Products Made from Chinese Gooseberry (Kiwi)

Effect on the Improvement of Intestinal Function and Constipation of Products Made from Chinese Gooseberry (Kiwi)

Effect of Lactobacillus casei fermented Senna tora L. seeds and its active compound via muscarinic M3 signaling on the improvement of intestinal function in rats

We previously reported the potential of Senna tora L. seeds fermented by Lactobacillus casei (FSL) as a laxative agent in a loperamide-induced constipation rat model. Here, we examine the mechanism of action of FSL and its bioactive compound, revealed herein, on loperamide-induced constipation Sprague Dawley rat model. We identified the compound aurantio-obtusin (AO) using HPLC quantitative analysis. Rats were randomly assigned to six experimental groups (eight rats each)-normal and constipated groups (loperamide, FSL [100, 300, 500 mg/kg], and AO [1 mg/kg]). The FSL and AO-treated group showed an increase in the frequency, amount, and water content of feces in the constipated rat. Moreover, FSL and AO increased the intestinal transit speed in the constipated rat. Histological analysis revealed that FSL and AO recovered the intestinal mucus, the number of goblet cells, as well as thickness of the mucosa layer and muscle. Furthermore, the protein levels of the muscarinic acetylcholine receptor M3, which is involved in intestine contraction, were recovered in the FSL and AO-treated group. Its downstream signaling pathway (p-protein kinase C) was recovered by FSL and AO treatment. In conclusion, fermentation of S. tora L. seeds increases AO, which improves intestinal function, indicating that FSL is effective for treating constipation.

Preparation, characterization and improvement in intestinal function of polysaccharide fractions from okra

The purpose of this study was to investigate the effect of okra polysaccharides with similar molecular weight on intestinal ecology. After extraction, ethanol precipitation, deproteinization and purification, two polysaccharide fractions, named as water-extracted polysaccharides (WEP) and alkaline-extracted polysaccharides (AEP), were obtained. According to the results of high performance liquid chromatography, AEP contained mannose, rhamnose, galacturonic acid and galactose, while WEP was composed of galactose, rhamnose, fructose, arabinose, glucose, galacturonic acid and mannose. The compositions of intestinal microbiota were affected by the change of daily substrates. Meanwhile, the concentration of ammonia and gastrointestinal transit time decreased, the total short chain fatty acid (SCFA) levels, moisture of caecum content increased. These findings suggested that the effect of okra polysaccharides on intestinal microbiota was achieved by the output of detrimental compounds and the supply of nutrients. Besides, AEP supported a more pivotal role in manipulating gut microbiota than WEP.

Beneficial effects of extracellular polysaccharide from Rhizopus nigricans on the intestinal immunity of colorectal cancer mice

An extracellular polysaccharide (EPS1-1) extracted from the fermentation broth of Rhizopus nigricans has been proved to enhance the immunity of immunosuppressed mice. The purpose of this study was to investigate the beneficial effects of EPS1-1 on the intestinal immunity of mice with colorectal cancer induced by azoxymethane (AOM) and dextran sodium sulfate (DSS). The results showed that EPS1-1 could resist hydrolysis in an artificial stomach. Oral EPS1-1 modulated gut microbiota and increased the concentration of total short-chain fatty acids (SCFAs) in the feces of colorectal cancer mice compared with the AOM/DSS only-treated mice. Furthermore, EPS1-1 increased the villus length, ratio of villus length and crypt depth in colonic tissues, and improved the number of acid mucus-secreting goblet cells in mice with colorectal cancer. These findings suggest that EPS1-1 might play an important role in the improvement of intestinal function in mice with colorectal cancer, which indicate its strong potential as efficient bio-secure immunotherapy for clinical applications or adjuvant drug.

Multimodal Surgical Approach for Adult Patients With Chronic Intestinal Pseudo-Obstruction: Clinical and Psychosocial Long-term Outcomes

BackgroundClinical and psychosocial outcomes of a multimodal surgical approach for chronic intestinal pseudo-obstruction were analyzed in 24 patients who were followed over a 2- to 12-year period in a single center after surgery or intestinal/multivisceral transplant (CTx). MethodsThe main reasons for surgery were sub-occlusion in surgery and parenteral nutrition–related irreversible complications with chronic intestinal failure in CTx. ResultsAt the end of follow-up (February 2015), 45.5% of CTx patients were alive: after transplantation, improvement in intestinal function was observed including a tendency toward recovery of oral diet (81.8%) with reduced parenteral nutrition support (36.4%) in the face of significant mortality rates and financial costs (mean, 202.000 euros), frequent hospitalization (mean, 8.8/re-admissions/patient), as well as limited effects on pain or physical wellness. ConclusionsThrough psychological tests, transplant recipients perceived a significant improvement of mental health and emotional state, showing that emotional factors were more affected than were functional/cognitive impairment and social interaction.

Effect of Lactic Acid Bacteria-Fermented Mulberry Leaf Extract on the Improvement of Intestinal Function in Rats.

This study examined the laxative effects of mulberry leaf extract (MLE) fermented by lactic acid bacteria (LAB), which contains high levels of polyphenolic and flavonoid compounds, against loperamide-induced constipation in rats. Sprague-Dawley rats were divided into a normal group (N) and three experimental groups; loperamide treated group (C), loperamide and LAB-fermented MLE 300 mg/kg treated group (MLEL), and loperamide and LAB-fermented MLE 600 mg/kg treated group (MLEH). After 33 d, fecal pellet amount, fecal weight, water content of fecal, gastrointestinal transit time and length, and serum lipid profiles were measured. Constipation was induced via subcutaneous injection of loperamide (2.0 mg/kg b.w., twice a day) for the final 5 d of the experiment. After loperamide administration, the LAB-fermented MLE groups showed a significantly increase in the fecal pellets number, wet weight, and water content in rats compared with the C group. Moreover, increases in the intestinal length and viable Lactobacillus numbers in the feces were observed in the LAB-fermented MLE groups. The intestinal transit time was shorter in the LAB-fermented MLE groups than in the C group. In addition, the LAB-fermented MLE groups showed a significant decrease in triglyceride and total cholesterol levels and an increase in HDL-cholesterol level. These results indicated that oral administration of LAB-fermented MLE shows laxative effect in loperamide-induced constipated rats.

Effect of Dendrobium speciosum Var. Aqueous Extract on Loperamide-Induced Constipation in Rats

Background : Irregular meals and insufficient exercise are major modern lifestyle-related risk factors for constipation. This study aimed to examine the effects of the aqueous extract of Dendrobium speciosum var. (DM) on the improvement of intestinal function and prevention of constipation in rats. Methods and Results : Constipation in rat was induced by loperamide (4 mg/kg) injection for 5 days and rats were randomly assigned to the following groups: normal control rats (NOR), constipated rats (LOP induced) and constipated rats supplemented with dulcolax-S (POS), DMSG, 100 mg/kg (DMSG-100), 300 mg/kg (DMSG-300) and 500 mg/kg (DMSG-500). The DMSG groups showed increments in the frequency and amount of stools compared to the LOP group. Loperamide treatment markedly reduced the water content of feces, whereas DMSG administration significantly increased fecal water contents. Moreover, DMSG improved intestinal transit speed in constipated-rats. Alcian blue staining revealed increased mucus production by crypt cells and mucus contents in feces and the mucosal surface. Conclusions : In summary, DM extraction significantly improves intestinal function in rats, which indicates the effectiveness of this extract in the prevention and treatment of constipation.

불용성 함초 식이섬유의 섭취가 흰쥐 장기능에 미치는 효과

Department of Biomedical Laboratory Science, Inje UniversityAbstract This study investigated the effect of insoluble dietary fibers extracted from Salicornia herbacea L. (S.herbacea) on the improvement of intestinal function in rats. Sprague-Dawley rats were fed on diet containing 5% and 10%S. herbacea dietary fiber (SHDF) for four weeks. Rats receiving the SHDF diet showed a significant decrease in theirtriglyceride levels and an increase in HDL-cholesterol levels. In addition, compared with the control group, the SHDFgroup showed a significant increase in the total quantity of the feces and its moisture content. The intestinal transit timeof the feces was also shorter in this group. The pH of the feces decreased in all the other experimental groups. Particularly,the bile acid content of the feces and the thicknesses of the mucus layers showed significant recovery on SHDF intake.These results suggest that dietary fiber isolated from S. herbacea has a marked effect on the improvement of bowelfunction in rats with loperamide (2 mg/kg)-induced constipation.Keywords: insoluble dietary fiber, Salicornia herbacea L., constipation, bowel function

Immune Response and Intestinal Permeability in Children With Acute Gastroenteritis Treated With Lactobacillus rhamnosus GG: A Randomized, Double-Blind, Placebo-Controlled Trial

Probiotics have a possible role in the treatment of pediatric acute gastroenteritis. We report the effect of the probiotic Lactobacillus rhamnosus GG (LGG) on intestinal function, immune response, and clinical outcomes in Indian children with cryptosporidial or rotavirus diarrhea. Children with gastroenteritis aged 6 months to 5 years, testing positive for either rotavirus or Cryptosporidium species in stool (coinfections were excluded), were randomized to LGG (ATCC 53103) or placebo, once daily for 4 weeks. Baseline demographic and clinical details were obtained. Sera were tested for immunoglobulin G (IgG) and immunoglobulin A (IgA) antibodies to Cryptosporidium and rotavirus, and the lactulose to mannitol ratio for intestinal permeability was determined at baseline and at the end of follow-up. Of the 124 children enrolled, 82 and 42 had rotavirus and cryptosporidial diarrhea, respectively. Median diarrheal duration was 4 days; one-third of the children had severe diarrhea. Baseline and clinical parameters were comparable between children receiving LGG and placebo. At the end of follow-up, fewer children with rotavirus diarrhea on LGG had repeated diarrheal episodes (25% vs 46%; P = .048) and impaired intestinal function (48% vs 72%; P = .027). Significant increase in IgG levels postintervention (456 vs 2215 EU; P = .003) was observed in children with rotavirus diarrhea receiving LGG. Among children with cryptosporidial diarrhea, those receiving LGG showed significant improvement in intestinal permeability. LGG has a positive immunomodulatory effect and may be useful in decreasing repeated episodes of rotavirus diarrhea. Improvement in intestinal function in children with rotavirus and cryptosporidial gastroenteritis emphasizes the role of probiotics in treating intestinal impairment after infection. CTRI/2010/091/000339.

Effects of Sargassum fusiforme polysaccharides on antioxidant activities and intestinal functions in mice

Sargassum fusiforme is a kind of brown algae that has been widely consumed not only as food, but also as herbal medicine for thousands of years. The purpose of this study was to investigate the antioxidant activities and intestinal functions of polysaccharides extracted from S. fusiforme (SFP) in normal and cyclophosphamide-induced immunosuppressed mice. The experiment was performed on six groups of ICR mice, which treated with cyclophosphamide (CY, 200mg/kg) or different dosages of SFP for 14 days. The results showed that administration of SFP was able to overcome the immunosuppression, and significantly increased the spleen index and antioxidant activities in mice (P<0.05). It also remarkably improved the numbers of jejunal intraepithelial lymphocytes (IELs) and goblet cells in immunosuppressed mice (P<0.05). For normal mice, SFP increased both thymus index and intestinal function parameters such as villus length/crypt depth ratio and intestinal IELs and goblet cells (P<0.05). The results suggested that SFP, possessing pronounced antioxidant activities, may play an important role in the improvement of intestinal function in mice. This might be one of the possible mechanisms of SFP for the immunomodulatory effects.

IgE-dependent mast cell hyperplasya in the intestine of cystic fibrosis mouse model needs KCNN4 channel activity.

Event Abstract Back to Event IgE-dependent mast cell hyperplasya in the intestine of cystic fibrosis mouse model needs KCNN4 channel activity. Texia T. Riquelme1, L.Pablo Cid1, Francisco V. Sepulveda1 and Carlos A. Flores1* 1 Centro de Estudios Científicos, Chile Cystic fibrosis (CF) primary dysfunction in epithelial transport concurs with deregulation of the immune system in human patients and animal models. We observed that when the KCNN4 channel is genetically silenced in the CF mouse lethality is drastically reduced with no improvement of intestinal function. The KCNN4 channel is broadly expressed including the immune system. We aim to test if KCNN4 channel inhibition is involved in immune system dysfunctions associated with CF. CF animals presented a 4-fold increase of intestinal mast cells, the value obtained in the KCNN4-null/CF mice was lower and comparable to controls. IgE-induced migration was 2-fold increased in control and CF mast cells compared with non-stimulated cells. Migration was blocked when the KCNN4 specific inhibitor TRAM-34 was used. Migration was completely impaired in the KCNN4-null and KCNN4-null/CF cells. Serum IgE level was increased in the CF as in the KCNN4-null/CF mice. Inhibition of KCNN4 blocks migration in control and CF mast cells. Hyperplasia of mast cells in the CF mice is localized in the intestinal tissue and can be due to increased migration induced by the higher levels of IgE. Mast cell reduction on intestine of KCNN4-null/CF mice is due to the impairment in migration of mast cells and not to reduced IgE levels. The origin of IgE in the CF mice remains a matter of investigation. KCNN4 inhibtion can be a useful pharmacological target on inflammatory CF disease where mast cells can act as enhancers of inflammation. Acknowledgements FONDECYT 111408 and CONICYT-BFP Keywords: IgE, Mast Cells, Kcnn4, Cystic Fibrosis, mice models Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Innate immunity Citation: Riquelme TT, Cid L, Sepulveda FV and Flores CA (2013). IgE-dependent mast cell hyperplasya in the intestine of cystic fibrosis mouse model needs KCNN4 channel activity.. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.01071 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 09 Jul 2013; Published Online: 22 Aug 2013. * Correspondence: Dr. Carlos A Flores, Centro de Estudios Científicos, Valdivia, Los Rios, Chile, cflores@cecs.cl Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Texia T Riquelme L.Pablo Cid Francisco V Sepulveda Carlos A Flores Google Texia T Riquelme L.Pablo Cid Francisco V Sepulveda Carlos A Flores Google Scholar Texia T Riquelme L.Pablo Cid Francisco V Sepulveda Carlos A Flores PubMed Texia T Riquelme L.Pablo Cid Francisco V Sepulveda Carlos A Flores Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Improvement in intestinal function of hamsters as influenced by consumption of polysaccharide-rich sage weed extracts

Abstract The purpose of this study was to investigate the effect of the water-soluble polysaccharide-rich sage weed (Salvia plebeia) extracts on intestinal function. The results showed that the extract is rich in water-soluble polysaccharides (60.5/100 g extract), which are mainly composed of pectic polysaccharides and hemicellulose. The inclusion of sage weed extract in the control diet at a level of 0.5/100 g diet resulted in significantly (P d -glucuronidase, β- d -glucosidase, mucinase, and urease. These findings suggest that an adequate intake of sage weed extracts (0.5/100 g diet) may play a role in the maintenance of intestinal health by reducing the exposure of intestinal mucosa to toxic materials and other harmful compounds.

Systematic review: medical and nutritional interventions for the management of intestinal failure and its resultant complications in children

Intestinal failure (IF) affects a growing number of children due to increasing numbers of preterm infants surviving intestinal resection for necrotising enterocolitis and improving surgical techniques for congenital gut anomalies. Parenteral nutrition (PN) is the mainstay of therapy; enteral nutrition may have trophic effects on the gut. To review systematically evidence for the effectiveness of medical and nutritional interventions in the treatment of IF in children. Retrieval of data from studies of patients aged <18 years and receiving >28 days of PN. Outcome measures were improvement in intestinal function, intestinal adaptation, growth, prevention and treatment of IF-associated liver disease, and mortality. Cochrane Database (November 2009), MEDLINE (1950-November 2009) and CINAHL (1982-November 2009) electronic database searches were made using keyword and subject headings (MeSH): IF, Short Bowel Syndrome (SBS), PN and Child. The level of the evidence (EL) was assessed using SIGN (Scottish Intercollegiate Guidelines Network) methodology (http://www.sign.ac.uk). From 1 607 620 hits, 720 abstracts were reviewed. Thirty-three original articles were included. No studies were of high methodological quality. The evidence base for medical and nutritional interventions in paediatric IF is limited and of poor quality. In the absence of randomised-controlled trials, this evidence base can improve through case control and cohort research; and with better multiagency communication, the study of inter-centre differences is possible. Achievable short-term goals would include the study of: optimal ursodeoxycholic usage, novel intralipid formulations, cycled enteral antibiotics, enteral probiotics and new enteral feeding strategies.

Improvement in intestinal function and health by the peel fibre derived from Citrus sinensis L cv Liucheng

AbstractThe water‐insoluble fibre‐rich fraction (WIFF) was isolated from the peel of Citrus sinensis L cv Liucheng in an economical way. The influences of a WIFF‐containing diet on the intestinal function and health in hamsters were investigated and compared with those of cellulose‐added and fibre‐free diets. Our results showed that the inclusion of WIFF in a fibre‐free diet might result in some significant improvements in serum, intestinal, caecal and faecal parameters, such as elevated serum alkaline phosphatase activity (127%), increased intestinal maltase and sucrase activities (180 and 164% respectively), decreased caecal pH (6.30), reduced caecal and faecal ammonia contents (by 25.4 and 34.1% respectively) and decreased activities of faecal β‐D‐glucosidase (by 48.1%), β‐D‐glucuronidase (by 52.9%) and urease (by 81.5%). These results suggested that the incorporation of WIFF in the diet at a level of 50 g kg−1 might exert a favourable effect on intestinal function and health. Accordingly, WIFF could be exploited as a potential functional ingredient in human diets and also offer industries an opportunity to develop new formulations of fibre‐rich functional foods. Copyright © 2005 Society of Chemical Industry

Reconstruction for chronic dysfunction of ileoanal pouches.

A retrospective review was performed to determine the results after surgical reconstruction for chronic dysfunction of ileal pouch-anal procedures for ulcerative colitis and familial colonic polyposis at a university medical center. During the 20-year period from 1978 to 1998, 601 patients underwent colectomy and ileal pouch-anal anastomosis (IPAA) for ulcerative colitis, familial colonic polyposis, or Hirschsprung's disease. A J pouch was used for 351 patients, a lateral pouch for 221, an S pouch for 6, and a straight pull-through for 23. Acute complications after pouch construction have been detailed in previous publications and are not included in this study. Chronic pouch stasis with diarrhea, frequency, urgency, and soiling gradually became more severe in 164 patients (27.3%), associated with pouch enlargement, an elongated efferent limb, and obstruction to pouch outflow, largely related to the pouch configuration used during the authors' early clinical experience. These patients were sufficiently symptomatic to be considered for reconstruction (mean 68 months after IPAA). Transanal resection of an elongated IPAA spout was performed on 58 patients; abdominoperineal mobilization of the pouch with resection and tapering of the lower end (AP reconstruction) and ileoanal anastomosis on 83; pouch removal and new pouch construction on 7; and conversion of a straight pull-through to a pouch on 16. Good long-term results (mean 7.7 years) with improvement in symptoms occurred in 98% of transanal resections, 91.5% of AP reconstructions, 86% of new pouch constructions, and 100% of conversions of a straight pull-through to a pouch. The average number of bowel movements per 24 hours at 6 months was 4.8. Complications occurred in 11.6% of reconstructed patients. Five of the 164 patients (3.1%) required eventual pouch removal and permanent ileostomy. The high rate of pouch revision in this series of patients undergoing IPAA is due to a policy of aggressive correction when patients do not experience an optimal functional result, or have a progressive worsening of their status. Although occasionally a major undertaking, reconstruction of ileoanal pouches with progressive dysfunction due to large size or a long efferent limb has resulted in marked improvement in intestinal function in >93% of patients and has reduced the need for late pouch removal.

Laboratory aids in the diagnosis of malabsorption in pediatrics: II. Xylose absorption test

The value of d -xylose absorption in assessing intestinal absorption of simple sugars was studied in the pediatric age group. Twenty per cent or more of the oral dose of xylose is recovered in a 5 hour urine collection from normal control subjects. Abnormal values for the xylose absorption are found primarily in the diseases with impaired absorption of both fat and carbohydrates from the upper small intestine, such as gluten-induced enteropathy. The xylose absorption test is of particular use in conjunction with a determination of fecal fat content or the Lipiodol absorption test in the differential diagnosis of the diseases leading to malabsorption and is recommended in patients with gluten-induced enteropathy as a simple and sensitive method for evaluating improvement in intestinal function on dietary therapy.