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Effects of Glutamine on Gastrointestinal Motor Activity in Patients following Gastric Surgery

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Abstract

Background

Postoperative ileus (POI) is one of the most common complications of gastrointestinal surgery. The present study was performed to evaluate the effects of glutamine administration on POI after gastric surgery in humans.

Subjects and methods

The subjects were 31 patients who underwent partial distal gastrectomy for gastric cancer and who were randomly assigned to one of two groups based on postoperative treatment: the glutamine group (3 g/day) and the control group. Manometric recording was done 12 days after surgery, and plasma glutamine concentrations were measured preoperatively and on postoperative day 12.

Results

Motor activities of the duodenum in the glutamine group were significantly greater than those of the control group in the interdigestive state. The incidence of phase III motor activity (interdigestive migrating motor contractions) in the glutamine group was significantly higher than that in the control group (60 versus 19%). The glutamine group showed a significantly smaller decrease of plasma glutamine levels compared with the control group.

Conclusions

Glutamine could act as a motility-recovery agent after gastrectomy in humans.

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References

  1. Kehlet H, Holte K (2001) Review of postoperative ileus. Am J Surg 182(5A Suppl):3S–10S

    Article  PubMed  CAS  Google Scholar 

  2. Mochiki E, Asao T, Kuwano H (2007) Gastrointestinal motility after digestive surgery. Surg Today 37:1023–1032

    Article  PubMed  Google Scholar 

  3. Holte K, Kehlet H (2000) Postoperative ileus: a preventable event. Br J Surg 87:1480–1493

    Article  PubMed  CAS  Google Scholar 

  4. Wilmore DW (2001) The effect of glutamine supplementation in patients following elective surgery and accidental injury. J Nutr 131(9 Suppl):2543S–2549S (discussion 2550S–2551S)

    PubMed  CAS  Google Scholar 

  5. Parry-Billings M, Baigrie RJ, Lamont PM et al (1992) Effects of major and minor surgery on plasma glutamine and cytokine levels. Arch Surg 127:1237–1240

    PubMed  CAS  Google Scholar 

  6. Wilmore DW (2000) Metabolic response to severe surgical illness: overview. World J Surg 24:705–711

    Article  PubMed  CAS  Google Scholar 

  7. Roth E, Funovics J, Muhlbacher F et al (1982) Metabolic disorders in severe abdominal sepsis: glutamine deficiency in skeletal muscle. Clin Nutr 1:25–41

    Article  PubMed  CAS  Google Scholar 

  8. Ward N (2003) Nutrition support to patients undergoing gastrointestinal surgery. Nutr J 2:18

    Article  PubMed  Google Scholar 

  9. Askanazi J, Hensle TW, Starker PM et al (1985) Effect of immediate postoperative nutritional support on length of hospitalization. Ann Surg 203:236–239

    Article  Google Scholar 

  10. Ziegler TR, Young LS, Benfell K et al (1992) Clinical and metabolic efficacy of glutamine-supplemented parenteral nutrition after bone marrow transplantation. A randomized, double-blind, controlled study. Ann Int Med 116:821–828

    PubMed  CAS  Google Scholar 

  11. Ohno T, Mochiki E, Ando H et al (2009) Glutamine decreases the duration of postoperative ileus after abdominal surgery: an experimental study of conscious dogs. Dig Dis Sci 54:1208–1213

    Article  PubMed  Google Scholar 

  12. Souba WW, Klimberg VS, Plumley DA et al (1990) The role of glutamine in maintaining a healthy gut and supporting the metabolic response to injury and infection. J Surg Res 48:383–391

    Article  PubMed  CAS  Google Scholar 

  13. Lacey JM, Wilmore DW (1990) Is glutamine a conditionally essential amino acid? Nutr Rev 48:297–309

    Article  PubMed  CAS  Google Scholar 

  14. Mittendorfer B, Gore DC, Herndon DN et al (1999) Accelerated glutamine synthesis in critically ill patients cannot maintain normal intramuscular free glutamine concentration. JPEN J Parenter Enteral Nutr 23:243–250 discussion 250–252

    Article  PubMed  CAS  Google Scholar 

  15. Delaney CP (2004) Clinical perspective on postoperative ileus and the effect of opiates. Neurogastroenterol Motil 16(Suppl 2):61–66

    Article  PubMed  Google Scholar 

  16. Augestad KM, Delaney CP (2010) Postoperative ileus: impact of pharmacological treatment, laparoscopic surgery and enhanced recovery pathways. World J Gastroenterol 16:2067–2074

    Article  PubMed  Google Scholar 

  17. Uemura K, Tatewaki M, Harris MB et al (2004) Magnitude of abdominal incision affects the duration of postoperative ileus in rats. Surg Endosc 18:606–610

    Article  PubMed  CAS  Google Scholar 

  18. Schippers E, Holscher AH, Bollschweiler E et al (1991) Return of interdigestive motor complex after abdominal surgery. End of postoperative ileus? Dig Dis Sci 36:621–626

    Article  PubMed  CAS  Google Scholar 

  19. Coelho JC, Gouma DJ, Moody FG et al (1985) Gastrointestinal myoelectric activity following abdominal operations in the opossum. World J Surg 9:612–618

    Article  PubMed  CAS  Google Scholar 

  20. Mochiki E, Satoh M, Tamura T et al (1996) Exogenous motilin stimulates endogenous release of motilin through cholinergic muscarinic pathways in the dog. Gastroenterology 111:1456–1464

    Article  PubMed  CAS  Google Scholar 

  21. Thomas S, Prabhu R, Balasubramanian KA (2005) Surgical manipulation of the intestine and distant organ damage—protection by oral glutamine supplementation. Surgery 137:48–55

    Article  PubMed  Google Scholar 

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Correspondence to Erito Mochiki.

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Mochiki, E., Ohno, T., Yanai, M. et al. Effects of Glutamine on Gastrointestinal Motor Activity in Patients following Gastric Surgery. World J Surg 35, 805–810 (2011). https://doi.org/10.1007/s00268-011-0962-5

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  • DOI: https://doi.org/10.1007/s00268-011-0962-5

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