EFFECT OF INTESTINAL RESECTION ON HUMAN SMALL-BOWEL MOTILITY

Background-Few data are available on adaptive changes of human small b owel motility after intestinal resection. Aim-To characterise jejunal motility after extensive and limited distal intestinal resection. Meth ods-Seven patients with a short bowel syndrome after total heal and pa rtial jejunal resection (residual jejunal segments between 60 and 100 cm) and six patients with limited distal ileal resection (resected seg ment between 30 and 70 cm) underwent ambulatory 24 hour jejunal manome try 15 (6-24) months after the operation. Normal values were obtained from 50 healthy subjects. Fasting motility and the motor response to a 600 kcal solid meal were analysed visually and by a computer program. Results-Limited ileal resection did not result in changed jejunal mot ility. After extensive distal resection, patients had a significantly shorter migrating motor complex (MMC) cycle and a significantly shorte r duration of the postprandial motor response compared with controls ( p<0 . 005). Intestinal resection had no influence on jejunal contracti on frequency and amplitude and did not lead to any abnormal motor patt ern. Conclusion-Extensive distal resection of the small intestine prod uces distinct abnormalities of fasting and postprandial motility in th e intestinal remnant. The shortening of digestive motility and the inc reased frequency of MMC cycling could contribute to malabsorption and diarrhoea in the short bowel syndrome.