METABOLIC ADAPTATION OF TERMINAL ILEAL MUCOSA AFTER CONSTRUCTION OF AN ILEOANAL POUCH

Background The major nutrients for the large bowel and small bowel muc osa are, respectively, butyrate and glutamine. The degree of mucosal a daptation that may occur in response to changes in nutrient supply and faecal stasis after the formation of an ileoanal pouch is poorly unde rstood. Method The ability of ileal mucosal biopsies, from nine patien ts with ulcerative colitis and from 18 with an ileoanal pouch, to oxid ize [C-14]-glucose, glutamine and butyrate to carbon dioxide was quant ified. Results Glucose, glutamine and butyrate were oxidized respectiv ely at a median of 12.5 (95 per cent confidence interval (4-22), 77 (3 4-207) and 194 (81-321) pmol mu g(-1) h(-1) by ileal mucosa and 12.9 ( 6-21), 35 (11-57) and 194 (73-737) pmol mu g(-1) h(-1) by pouch mucosa . Conclusion Ileoanal pouch construction and subsequent bacterial colo nization and faecal stasis resulted in a significant (P < 0.05) reduct ion in the mucosal ability to oxidize glutamine whereas there was no d ifference in the rate of butyrate oxidation.