Skip to main content
SpringerLink
Log in

Disproportionate ileal digestion on canine food consumption

A possible model for satiety in pancreatic insufficiency

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

In animals, ileal sensors of nutrients signal satiety more potently than similar sensors in jejunum. We postulated that inadequate food intake and weight loss in human pancreatic insufficiency might arise by the displacement of digestion to ileum, where excessive release of digestive products would enhance satiety. To test this idea, we studied dogs prepared with pancreatic fistulas, which allowed reversible switching of pancreatic juice from entry at duodenum to entry at mid-small intestine. Dogs were studied in a crossover design over successive eight-day periods. Food consumption and body weight were measured while the dogs had continuous access to food. Diversion of pancreatic juice to mid-intestine significantly (P<0.01) depressed food intake by an average of 28%. Diversion also significantly (P<0.01) reduced body weight. The findings support the idea that insufficient food intake in human pancreatic insufficiency may result from stimulation of ileal satiety mechanisms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Twersky Y, Bank S: Nutritional deficiencies in chronic pancreatitis. Gastroenterol Clin North Am 18:543–565, 1989

    PubMed  Google Scholar 

  2. Soutter VL, Kristidis P, Gruca MA, Gaskin KJ: Chronic undernutrition and growth retardation in cystic fibrosis. Clin Gastroenterol 15:137–155, 1986

    PubMed  Google Scholar 

  3. Meyer JH: Delivery of pancreatic enzymes in microsphere preparations: Transit, timing, physiological needs.In Pancreatic Enzymes in Health and Disease. PG Lankisch (ed). Berlin, Springer-Verlag, 1991, pp 71–88

    Google Scholar 

  4. Weigle DS: Human obesity—exploding the myths. West J Med 153:421–428, 1990

    PubMed  Google Scholar 

  5. Keys A, Brozek J, Henschel A, Mickelsen O, Taylor HL: Chapter 6.In The Biology of Human Starvation, Vol 1. Minneapolis, The University of Minnesota Press, 1950, pp 84–130

    Google Scholar 

  6. Buchdal RM, Fulleylove C, Marchant JL, Warner JO, Brueton M: Energy and nutrient intakes in cystic fibrosis. Arch Dis Child 64:373–378, 1989

    PubMed  Google Scholar 

  7. Boland MP, Stoski DS, MacDonald NE, Soucy P, Patrick J: Chronic jejunostomy feeding with a non-elemental formula in undernourished patients with cystic fibrosis. Lancet 1:232–234, 1986

    PubMed  Google Scholar 

  8. Levy LD, Duriew PR, Pencjarz PB, Corey M: Effects of longterm nutritional rehabilitation on body composition and clinical status in undernourished patients with cystic fibrosis. J Pediatr 107:225–230, 1985

    PubMed  Google Scholar 

  9. Shepherd RW, Holt TL, Thomas BJ, et al: Nutritional rehabilitation in cystic fibrosis: Controlled studies of effects on nutritional growth retardation, body protein turnover, and course of pulmonary disease. J Pediatr 109:788–794, 1986

    PubMed  Google Scholar 

  10. Borgstrom B, Dahlquist G, Lundh G, Sjovall J: Studies of intestinal digestion and absorption in the human. J Clin Invest 36:1521–1536, 1957

    PubMed  Google Scholar 

  11. Fogel MR, Gray GM: Starch hydrolysis in man: An intraluminal process not requiring membrane digestion. J Appl Physiol 35:263–267, 1973

    PubMed  Google Scholar 

  12. Doty JE, Meyer JH: Vagotomy and antrectomy impairs intracellular but not extracellular fat absorption in the dog. Gastroenterology 94:50–56, 1988

    PubMed  Google Scholar 

  13. Knoebel LK: Fat digestion and absorption in the proximal intestine of the dog. Proc Soc Expl Biol Med 109:558–561, 1962

    Google Scholar 

  14. Koopmans HS, Ferri GL, Sarson DL, Polak JM, Bloom SR: The effects of ileal transposition and jejunoileal bypass on food intake and GI hormone levels in rats. Physiol Behav 33:601–609, 1984

    PubMed  Google Scholar 

  15. Atkinson RL, Whipple JH, Atkinson SH, Stewart CC: Role of the small bowel in regulating food intake in rats. Am J Physiol 242:R429-R433, 1982

    PubMed  Google Scholar 

  16. Koopmans HS: An integrated organismic response to lower gut stimulation. Scand J Gastroenterol 18(suppl 182):143–153, 1983

    Google Scholar 

  17. Doty JE, Gu YG, Meyer JH: The effect of bile diversion on satiety and fat absorption from liquid and solid dietary sources. J Surg Res 45:537–543, 1988

    PubMed  Google Scholar 

  18. Doty JE, Sanders SL, Meyer JH: Effects of enteral feedings on gastric emptying and satiety. Gastroenterology 96:A128, 1989

    Google Scholar 

  19. Welch I, Saunders K, Read NW: Effect of ileal and intravenous infusions of fat emulsions on feeding and satiety in human volunteers. Gastroenterology 89:1293–1297, 1985

    PubMed  Google Scholar 

  20. Robinson RG, Folstein MF, McHugh PR: Reduced caloric intake following small bowel bypass surgery: a systematic study of possible causes. Psychol Med 9:37–53, 1979

    PubMed  Google Scholar 

  21. Condon SC, Janes NJ, Wise L, Alpers DH: Role of caloric intake in the weight loss after jejunoileal bypass for obesity. Gastroenterology 74:34–37, 1978

    PubMed  Google Scholar 

  22. Bray GA, Barry RE, Benfield JR, Castelnuovo-Tedesco P, Rodin J: Intestinal bypass surgery for obesity decreases food intake and taste preferences. Am J Clin Nutr 29:779–783, 1976

    PubMed  Google Scholar 

  23. Johansson C, Schmidt DN, Hellstrom PM: Changed integrated gastrointestinal response to a mixed meal in exocrine pancreatic insufficiency. Pancreas 7:205–211, 1992

    PubMed  Google Scholar 

  24. Guarner L, Rodriguez R, Guarner F, Malagelada J-R: Fate of oral enzymes in pancreatic insufficiency. Gut 34:708–712, 1993

    PubMed  Google Scholar 

  25. Herrera F, Kemp DR, Tsukamoto M, Woodward ER, Dragstedt LR: A new cannula for the study of pancreatic function. J Appl Physiol 25:107–209, 1968

    Google Scholar 

  26. Moran TH, McHugh PR: Cholecystokinin suppresses food intake by inhibiting gastric emptying. Am J Physiol 242:R491-R497, 1982

    PubMed  Google Scholar 

  27. Lin HC, Kim BH, Elashoff JD, Doty JE, Gu YG, Meyer JH: Gastric emptying of solid food is most potently inhibited by carbohydrate in canine distal ileum. Gastroenterology 102:793–801, 1992

    PubMed  Google Scholar 

  28. Bronstein MN, Sokol RJ, Abman SH, Chatfield BA, Hammond KB, Hambridge KM, Stall CD, Accurso FJ: Pancreatic insufficiency, growth, and nutrition in infants identified by newborn screening as having cystic fibrosis. J Pediatr 120:533–540, 1992

    PubMed  Google Scholar 

  29. Evans WB, Wollaeger EE: Incidence and severity of nutritional deficiency states in chronic exocrine pancreatic insufficiency: Comparison with non-tropical sprue. Am J Dig Dis 11:594–606, 1966

    PubMed  Google Scholar 

  30. Sproul A, Huang N: Growth patterns in children with cystic fibrosis. J Pediatr 65:664–676, 1964

    PubMed  Google Scholar 

  31. Lundh G: Intestinal digestion and absorption after gastrectomy. Acta Chir Scand (suppl 231):1–83, 1958

    Google Scholar 

  32. Meyer JH, Gu YG, Jehn D, Doty JE: Factors which affect the performance of lipase on fat digestion in a canine model of pancreatic insufficiency. Pancreas (in press)

  33. James AH: The nature of the gastric contents in man.In The Physiology of Gastric Digestion. AH James (ed). London, Edward Arnold, 1957, pp 1–24

    Google Scholar 

  34. Glick Z: Intestinal satiety with and without upper intestinal factors. Am J Physiol 236:R142-R146, 1979

    PubMed  Google Scholar 

  35. Meyer JH, Gu YG, Doty JE: Effect of replenished lipase on postcibal absorption of fat in a canine model of pancreatic insufficiency. Pancreas (in press)

  36. Holzer HH, Raybould HE: Vagal and splanchnic sensory pathways mediate inhibition of gastric motility induced by duodenal distension. Am J Physiol 262:G603-G608, 1992

    PubMed  Google Scholar 

  37. Keesey RE: Physiological regulation of body weight and the issue of obesity. Med Clin North Am 73:15–19, 1989

    PubMed  Google Scholar 

  38. Kissileff HR, VanItallie TB: Physiology of the control of food intake. Annu Rev Nutr 2:371–418, 1982

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. From the Department of Medicine and Surgery, Sepulveda VA Medical Center, USA

    J. H. Meyer MD, J. D. Elashoff PhD, J. E. Doty MD & Y. G. Gu MD

  2. the Biostatistics Unit, Cedars Sinai Medical Center, USA

    J. H. Meyer MD, J. D. Elashoff PhD, J. E. Doty MD & Y. G. Gu MD

  3. the UCLA School of Medicine, USA

    J. H. Meyer MD, J. D. Elashoff PhD, J. E. Doty MD & Y. G. Gu MD

Authors
  1. J. H. Meyer MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. D. Elashoff PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. E. Doty MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. G. Gu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was supported by a grant from the Cystic Fibrosis Foundation, Inc., and by research funds from the Department of Veteran Affairs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meyer, J.H., Elashoff, J.D., Doty, J.E. et al. Disproportionate ileal digestion on canine food consumption. Digest Dis Sci 39, 1014–1024 (1994). https://doi.org/10.1007/BF02087553

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02087553

Key words

Search

Navigation