The effect of enteral nutrition on exocrine pancreatic function

Article Abstract:

The most common method of providing nutrition to the patient after surgery is by parenteral feeding (feeding that bypasses the digestive tract). New evidence suggests an advantage to providing early enteral (via the digestive system) feeding. This technique is also less expensive than parenteral nutrition. Enteral nutrition can be administered directly to the jejunum (the second portion of the small intestine) through a needle catheter. The effect of this type of enteral nutrition on the secretion of pancreatic juice is not known. A study compared enteral feeding to total parenteral feeding to determine the effects of each on pancreatic exocrine function. Twelve patients with acute pancreatitis underwent surgery to remove the head of the pancreas and duodenum (first portion of the small intestine), but the remainder of the pancreas was retained and attached to the stomach. The pyloric area of the stomach, which had been severed from the duodenum, was then joined to the jejunum. Pancreatic juices were collected from a tube placed in the pancreatic duct at the time of surgery. Patients were randomly assigned to receive either total parenteral nutrition or enteral nutrition. There were no significant differences noted between the feeding groups. It is concluded that administration of nutrition to the jejunum does not stimulate the pancreas any more than parenteral nutrition does. Therefore, enteral nutrition has no apparent disadvantages for use in the postoperative care of patients with pancreatic disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Enteral feeding, Enteral nutrition

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Humoral control of gut function

Article Abstract:

The function of the gut, or intestines, is controlled by many mechanisms. The chemical messengers that regulate gastrointestinal (GI) function are the specialized gut hormones; these are secreted by endocrine cells and distributed throughout the GI tract. The topics covered in this address include: the effect of aging on gut hormones; actions of calcium-regulating hormones on the gut; circadian rhythms (patterns based on a 24-hour cycle and repetition of certain physiologic events such as sleeping and eating) in gut hormones; the role of receptors in the action of gut hormones; gut hormones under normal conditions and during tumor growth; and studies on the molecular biology of gut hormones. The process of aging causes changes in the gut, which has several implications. Acid secretion diminishes with increasing age, but the secretion of bicarbonate also diminishes, which may explain the increased incidence of duodenal ulcer disease associated with aging. With aging, contractions of the gallbladder are diminished; this appears to be due to a reduction in the concentration of receptors for the gastrin CCK (a general group of gut hormones). It is suggested that the mitosis (cell division) stimulating effects of the GI hormones on the growth of gut tissue may have clinical applications to treatment of GI cancers. Future research will examine the role of gut hormones at the gene level to provide a more exact understanding of their role and function. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Peptide hormones, Intestines, Speeches, lectures and essays, Gastrointestinal hormones, Bodily secretions

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Pancreatic regeneration after partial pancreatectomy

Article Abstract:

Following partial removal of the pancreas, the remnant tissue does not spontaneously undergo significant regeneration, as occurs in the liver. Gastrointestinal hormones have trophic (nourishing) effects on a normal pancreas. In rats, FOY-305 (an agent that stimulates cholecystokinin, a gastrointestinal hormone), stimulates growth in the normal pancreas. A study was conducted using rats to determine the effect of FOY-305 on pancreatic regeneration following partial removal of the pancreas. Rats given FOY-305 following partial pancreatectomy showed significant increase in growth in the pancreatic remnant compared with rats who were given only water following partial pancreatectomy. After 27 days of treatment, the extent of pancreatic regeneration exceeded the mass of a normal unresected pancreas. These results demonstrated the remarkable ability of the pancreas to regenerate following resection when FOY-305 is given. The pancreas had significant capacity for growth and regeneration. These findings may be clinically important for the future treatment of pancreatic insufficiency following partial pancreatic resection, regeneration after acute pancreatitis, and in treating chronic pancreatitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Regeneration (Biology), Trypsin inhibitors

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