Digestion and absorption in a man with all but three feet of the small intestine removed surgically

Summary

Metabolic studies were conducted on a case of regional ileitis possessing only three feet of small intestine. Balance experiments on carbohydrate, protein, fat, calcium and phosphorus were carried out. Caloric utilization was calculated from the data obtained.

Carbohydrates were utilized normally in all three periods of study. Proteins were not as well absorbed; 76%, 75% and 69% for the three periods. Of more interest is the fat metabolism due to its direct effect on calcium absorption. The data indicate that more calcium was lost when larger amounts of fats (largely as fatty acids) were excreted in the feces. Phosphorus excretion tended to parallel the excretion of calcium.

Tetany was obviated only by a very high calcium and Vitamin D (viosterol) diet and was controlled more easily with a high carbohydrate-low fat intake (Period 3).