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. 1993 Sep;34(9):1215–1218. doi: 10.1136/gut.34.9.1215

Colonic dysfunction in acute diarrhoea: the role of luminal short chain fatty acids.

B S Ramakrishna 1, V I Mathan 1
PMCID: PMC1375457  PMID: 8406157

Abstract

Faecal concentrations and output of short chain fatty acids (SCFA) were assessed on successive days by gas-liquid chromatography in 24 patients with acute watery diarrhoea. Absorption of water and sodium from the rectum was also measured by a dialysis technique in 17 of these patients and in nine normal subjects in the presence and absence of luminal SCFA. Faecal SCFA concentrations were low on the first day of diarrhoea (mean (SEM) 9.9 (5.8) mmol/kg) and increased to 94.8 (16.4) mmol/kg by the fifth day. Faecal output of SCFA corresponded to these figures. Net water absorption, in the absence of luminal SCFA, was stopped in patients with acute diarrhoea (-59 (81) nl/cm2/min) compared with healthy controls (+322 (63) nl/cm2/min) (p < 0.01). Luminal SCFA restored net water absorption to +184 (67) nl/cm2/min in patients with acute diarrhoea (p < 0.01). Net absorption of sodium decreased in patients with acute diarrhoea in the absence of luminal SCFA, but returned to normal with luminal SCFA. Net secretion of potassium increased in acute diarrhoea, and did not change in the presence of SCFA. Defective absorption from the rectum in acute diarrhoea is reversed by luminal SCFA. The reduction of luminal SCFA in acute diarrhoea treated conventionally may be a factor contributing to colonic dysfunction.

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Selected References

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  1. Albert M. J., Bhat P., Rajan D., Maiya P. P., Pereira S. M., Baker S. J. Faecal flora of South Indian infants and young children in health and with acute gastroenteritis. J Med Microbiol. 1978 May;11(2):137–143. doi: 10.1099/00222615-11-2-137. [DOI] [PubMed] [Google Scholar]
  2. Argenzio R. A., Moon H. W., Kemeny L. J., Whipp S. C. Colonic compensation in transmissible gastroenteritis of swine. Gastroenterology. 1984 Jun;86(6):1501–1509. doi: 10.1016/S0016-5085(84)80165-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Banwell J. G., Pierce N. F., Mitra R. C., Brigham K. L., Caranasos G. J., Keimowitz R. I., Fedson D. S., Thomas J., Gorbach S. L., Sack R. B. Intestinal fluid and electrolyte transport in human cholera. J Clin Invest. 1970 Jan;49(1):183–195. doi: 10.1172/JCI106217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Binder H. J., Mehta P. Characterization of butyrate-dependent electroneutral Na-Cl absorption in the rat distal colon. Pflugers Arch. 1990 Dec;417(4):365–369. doi: 10.1007/BF00370654. [DOI] [PubMed] [Google Scholar]
  5. Binder H. J., Mehta P. Short-chain fatty acids stimulate active sodium and chloride absorption in vitro in the rat distal colon. Gastroenterology. 1989 Apr;96(4):989–996. doi: 10.1016/0016-5085(89)91614-4. [DOI] [PubMed] [Google Scholar]
  6. CARPENTER C. C., CHAUDHURI R. N., MONDAL A. A SIMPLE EFFECTIVE THERAPY OF CHOLERA. Indian J Med Res. 1964 Aug;52:924–932. [PubMed] [Google Scholar]
  7. Cummings J. H., Englyst H. N. Fermentation in the human large intestine and the available substrates. Am J Clin Nutr. 1987 May;45(5 Suppl):1243–1255. doi: 10.1093/ajcn/45.5.1243. [DOI] [PubMed] [Google Scholar]
  8. Cummings J. H. Short chain fatty acids in the human colon. Gut. 1981 Sep;22(9):763–779. doi: 10.1136/gut.22.9.763. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Debongnie J. C., Phillips S. F. Capacity of the human colon to absorb fluid. Gastroenterology. 1978 Apr;74(4):698–703. [PubMed] [Google Scholar]
  10. Dobbins J. W., Binder H. J. Pathophysiology of diarrhoea: alterations in fluid and electrolyte transport. Clin Gastroenterol. 1981 Sep;10(3):605–625. [PubMed] [Google Scholar]
  11. Edmonds C. J. Absorption and secretion of fluid and electrolytes by the rectum. Scand J Gastroenterol Suppl. 1984;93:79–87. [PubMed] [Google Scholar]
  12. Edmonds C. J. Absorption of sodium and water by human rectum measured by a dialysis method. Gut. 1971 May;12(5):356–362. doi: 10.1136/gut.12.5.356. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Englyst H. N., Cummings J. H. Digestion of the carbohydrates of banana (Musa paradisiaca sapientum) in the human small intestine. Am J Clin Nutr. 1986 Jul;44(1):42–50. doi: 10.1093/ajcn/44.1.42. [DOI] [PubMed] [Google Scholar]
  14. Fleming S. E., Rodriguez M. A. Influence of dietary fiber on fecal excretion of volatile fatty acids by human adults. J Nutr. 1983 Aug;113(8):1613–1625. doi: 10.1093/jn/113.8.1613. [DOI] [PubMed] [Google Scholar]
  15. Gorbach S. L., Banwell J. G., Chatterjee B. D., Jacobs B., Sack R. B. Acute undifferentiated human diarrhea in the tropics. I. Alterations in intestinal micrflora. J Clin Invest. 1971 Apr;50(4):881–889. doi: 10.1172/JCI106560. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Illman R. J., Topping D. L., Trimble R. P. Effects of food restriction and starvation-refeeding on volatile fatty acid concentrations in the rat. J Nutr. 1986 Sep;116(9):1694–1700. doi: 10.1093/jn/116.9.1694. [DOI] [PubMed] [Google Scholar]
  17. Lebenthal E. Rice as a carbohydrate substrate in oral rehydration solutions (ORS). J Pediatr Gastroenterol Nutr. 1990 Oct;11(3):293–296. [PubMed] [Google Scholar]
  18. Levin R. J., Parker A. J. Rectal electrogenic secretion--is it a putative indicator of intestinal secretory status induced by nutritional deprivation in the rat? Exp Physiol. 1990 Jul;75(4):609–611. doi: 10.1113/expphysiol.1990.sp003438. [DOI] [PubMed] [Google Scholar]
  19. Molla A. M., Ahmed S. M., Greenough W. B., 3rd Rice-based oral rehydration solution decreases the stool volume in acute diarrhoea. Bull World Health Organ. 1985;63(4):751–756. [PMC free article] [PubMed] [Google Scholar]
  20. Molla A. M., Molla A., Nath S. K., Khatun M. Food-based oral rehydration salt solution for acute childhood diarrhoea. Lancet. 1989 Aug 19;2(8660):429–431. doi: 10.1016/s0140-6736(89)90601-6. [DOI] [PubMed] [Google Scholar]
  21. Molla A. M., Molla A., Rohde J., Greenough W. B., 3rd Turning off the diarrhea: the role of food and ORS. J Pediatr Gastroenterol Nutr. 1989 Jan;8(1):81–84. doi: 10.1097/00005176-198901000-00015. [DOI] [PubMed] [Google Scholar]
  22. Ramakrishna B. S., Mathan V. I. Absorption of water and sodium and activity of adenosine triphosphatases in the rectal mucosa in tropical sprue. Gut. 1988 May;29(5):665–668. doi: 10.1136/gut.29.5.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Ramakrishna B. S., Nance S. H., Roberts-Thomson I. C., Roediger W. E. The effects of enterotoxins and short-chain fatty acids on water and electrolyte fluxes in ileal and colonic loops in vivo in the rat. Digestion. 1990;45(2):93–101. doi: 10.1159/000200229. [DOI] [PubMed] [Google Scholar]
  24. Read N. W. Diarrhoea: the failure of colonic salvage. Lancet. 1982 Aug 28;2(8296):481–483. doi: 10.1016/s0140-6736(82)90504-9. [DOI] [PubMed] [Google Scholar]
  25. Roediger W. E., Moore A. Effect of short-chaim fatty acid on sodium absorption in isolated human colon perfused through the vascular bed. Dig Dis Sci. 1981 Feb;26(2):100–106. doi: 10.1007/BF01312224. [DOI] [PubMed] [Google Scholar]
  26. Roediger W. E., Rae D. A. Trophic effect of short chain fatty acids on mucosal handling of ions by the defunctioned colon. Br J Surg. 1982 Jan;69(1):23–25. doi: 10.1002/bjs.1800690108. [DOI] [PubMed] [Google Scholar]
  27. Ruppin H., Bar-Meir S., Soergel K. H., Wood C. M., Schmitt M. G., Jr Absorption of short-chain fatty acids by the colon. Gastroenterology. 1980 Jun;78(6):1500–1507. [PubMed] [Google Scholar]
  28. Scheppach W., Fabian C., Sachs M., Kasper H. The effect of starch malabsorption on fecal short-chain fatty acid excretion in man. Scand J Gastroenterol. 1988 Aug;23(6):755–759. doi: 10.3109/00365528809093945. [DOI] [PubMed] [Google Scholar]
  29. Speelman P., Butler T., Kabir I., Ali A., Banwell J. Colonic dysfunction during cholera infection. Gastroenterology. 1986 Nov;91(5):1164–1170. doi: 10.1016/s0016-5085(86)80012-9. [DOI] [PubMed] [Google Scholar]
  30. Whitehead J. S., Kim Y. S., Prizont R. A simple quantitative method to determine short chain fatty acid levels in biological fluids. Clin Chim Acta. 1976 Nov 1;72(3):315–318. doi: 10.1016/0009-8981(76)90193-5. [DOI] [PubMed] [Google Scholar]

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