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Comparison of absorption of nutrients and secretion of water between oligomeric and polymeric enteral diets in pigs

Published online by Cambridge University Press:  09 March 2007

Hansjörg Ehrlein*
Affiliation:
Institute of Physiology, University of Hohenheim, Stuttgart, Germany
Benedikt Haas-Deppe
Affiliation:
Institute of Physiology, University of Hohenheim, Stuttgart, Germany
*
*Professor H. J. Ehrlein, fax +49 711 459 3726, email [email protected]
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Abstract

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In patients who require enteric tube-feeding the osmolality of the formulas is assumed to play an important role. There is the dilemma that osmolality increases as the digestibility of formulas is enhanced by means of degradation of the nutrients. Hitherto there have been no reports of whether there are differences in nutrient absorption and water fluxes between iso-osmotic polymeric and hyperosmotic oligomeric diets. We therefore investigated absorption of nutrients and net fluxes of water during perfusion of a 1·5 m jejunal segment with oligomeric, polymeric and commercial oligopeptide diets either in the absence of pancreatic juice or with concomitant infusion of pancreatic enzymes. In the absence of pancreatic juice the absorption rates of the polymeric diet and the commercial oligopeptide diets reached 58·0 and 84·5 % respectively of that of a completely-hydrolysed hyperosmotic oligomeric diet. The concomitant infusion of pancreatic enzymes with the polymeric and oligopeptide diets significantly increased the absorption rates of nutrients and energy. The highest absorption rate of energy occurred with the commercial formula Survimed® (Fresenius, Bad Homburg, Germany), probably due to an optimal composition of the macronutrients. The increase in absorption due to the degradation of nutrients by pancreatic enzymes was associated with an increase in net water secretion and flow-rate, reaching similar values to those with the hyperosmotic oligomeric diet. It may be concluded that iso-osmotic oligopeptide formulas require further pancreatic hydrolysis for optimum absorption. In patients with normal pancreatic secretion, oligopeptide formulas have no advantage over polymeric diets. In patients with reduced pancreatic secretion, either completely-hydrolysed hyperosmotic oligomeric diets or polymeric diets supplemented with pancreatic enzymes are appropriate.

Type
Research Article
Copyright
Copyright © The Nutrition Society 1998

References

Alpers, DH (1994) Digestion and absorption of carbohydrates and proteins. In Physiology of the Gastrointestinal Tract, pp. 17231749 [Johnson, LR, editor]. New York, NY: Raven Press.Google Scholar
Dahlquist, A & Thomson, DL (1963) Separation and characteristics of two rat-intestinal amylases. Biochemical Journal 89, 272277.CrossRefGoogle Scholar
Fogel, MR & Gray, GM (1973) Starch hydrolysis in man: an intraluminal process not requiring membrane digestion. Journal of Applied Physiology 35, 263267.Google Scholar
Gorman, RC & Morris, JB (1997) Minimally invasive access to the gastrointestinal tract. In Clinical Nutrition: Enteral and Tube Feeding, pp. 174192 [Rombeau, JL and Rolandelli, RH, editors]. Philadelphia and London: W.B. Saunders.Google Scholar
Gotteland, MM, Shronts, EP & Hutchins, AM (1997) Defined formula diets. In Clinical Nutrition: Enteral and Tube Feeding, pp. 207239 [Rombeau, JL and Rolandelli, RH, editors]. Philadelphia and London: W.B. Saunders.Google Scholar
Jesuitova, N, DeLaey, P & Ugolev, AM (1964) Digestion of starch in vivo and in vitro in a rat intestine. Biochimica et Biophysica Acta 86, 205210.CrossRefGoogle Scholar
Jones, BJM, Brown, BE, Loran, JS, Edgerton, D, Kennedy, JF, Stead, JA & Silk, DBA (1983) Glucose absorption from starch hydro-lysates in the human jejunum. Gut 24, 11521160.Google Scholar
Kirby, DF & Fleming, CR (1995) American Gastroenterological Association Medical Position Statement: Guidelines for the use of enteral nutrition. Gastroenterology 108, 12801301.CrossRefGoogle Scholar
McCamish, MA, Bounous, G & Geraghty, ME (1997) History of enteral feeding: past and present perspectives. In Clinical Nutrition: Enteral and Tube Feeding, pp. 111 [Rombeau, JL and Rolandelli, RH, editors]. Philadelphia and London: W.B. Saunders.Google Scholar
McGeachin, RL & Ford, NJ (1959) Distribution of amylase in the gastrointestinal tract of the rat. American Journal of Physiology 196, 972974.Google Scholar
McGeachin, RL, Gleason, JR & Adams, NR (1958) Amylase distribution in extrapancreatic, extrasalivary tissues. Archives of Biochemistry and Biophysics 75, 403411.CrossRefGoogle ScholarPubMed
Miller, LJ, Malagelada, JR & Go, VLW (1978) Postprandial duodenal function in man. Gut 19, 699706.CrossRefGoogle ScholarPubMed
Modigliani, R, Rambaud, JC & Bernier, JJ (1973) The method of intraluminal perfusion of the human small intestine. 1. Principle and technique. Digestion 9, 176192.CrossRefGoogle Scholar
Steinhardt, HJ, Wolf, A, Jakober, B, Schmuelling, RM, Langer, K, Brandl, M, Fekl, W & Adibi, SA (1989) Nitrogen absorption in pancreatectomized patients: protein versus protein hydro-lysate as substrate. Journal of Laboratory and Clinical Medicine 113, 162167.Google ScholarPubMed
Ugolev, AM (1960) Influence of the surface of the small intestine on enzymatic hydrolysis of starch by enzymes. Nature 188, 588589.CrossRefGoogle ScholarPubMed
Weber, E (1996) Beziehungen zwischen der Magenentleerung von Nährstoffen und der Resorptionskapazität des Dünndarms beim Schwein (Relationships between gastric emptying of nutrients and absorptive capacity of small intestine in pig). Dissertation, University of Hohenheim.Google Scholar
Weber, E & Ehrlein, HJ (1998) Relationships between gastric emptying and intestinal absorption of nutrients and energy in minipigs. Digestive Diseases and Sciences 43 11411153.CrossRefGoogle Scholar