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Wirkung von Ballaststoffen, kurzkettigen Fettsäuren und Glutamin auf die Funktion des Dünn- und Dickdarms

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Zusammenfassung

Traditionell wird der nutritive Aspekt der enteralen Substratzufuhr in den Vordergrund der Betrachtung gestellt. Diese Sichtweise vernachlässigt, daß Inhaltsstoffe der Nahrung Struktur und Funktion des Intestinaltrakts nachhaltig beeinflussen. Beispielhaft sei der trophische Effekt einer enteralen Ernährung auf die Zottenhöhe des Jejunums genannt; die orale Nahrungskarenz führt binnen weniger Tage zur Epithelatrophie. Unter den luminalen „Schlüsselsubstanzen“ scheinen die beim Ballaststoffabbau entstehenden kurzkettigen Fettsäuren für das Kolon und die Aminosäure L-Glutamin für den Dünndarm von besonderer Bedeutung zu sein.

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Literatur

  1. Aghdassi E, Plapler H, Kurian R, Raina N, Royall D, Jeejeebhoy KN et al. (1994) Colonic fermentation and nutritional recovery in rats with massive small bowel resection. Gastroenterology 107:637–642PubMedCrossRefGoogle Scholar
  2. Bartram HP, Scheppach W, Heid C, Fabian C, Kasper H (1991) Effect of starch malabsorption on fecal bile acids and neutral sterols in humans: Possible implications for colonic carcinogenesis. Cancer Res 51:4238–4242PubMedGoogle Scholar
  3. Bartram HP, Scheppach W, Schmid H, Hofmann A, Dusel G, Richter F et al. (1993) Proliferation of human colonic mucosa as an intermediate biomarker of carcinogenesis: effects of butyrate, deoxycholate, calcium, ammonia, and pH. Cancer Res 53:3283–3288PubMedGoogle Scholar
  4. Blackburn NA, Redfern JS, Jarjis H, Holgate AM, Hanning I, Scarpello JHB et al. (1984) The mechanism of action of guar gum in improving glucose tolerance in man. Clin Sci 66:329–336PubMedGoogle Scholar
  5. Breuer RI, Soergel KH, Lashner BA, Christ ML, Hanauer SB, Vanaguas A et al. (1997) Short chain fatty acid rectal irrigation for left-sided ulcerative colitis: a randomised, placebo controlled trial. Gut 40:485–491PubMedGoogle Scholar
  6. Cummings JH, Englyst HN (1991) Measurement of starch fermentation in the human large intestine. Can J Physiol Pharmacol 69:121–129PubMedCrossRefGoogle Scholar
  7. Deng G, Liu G, Hu L, Gum JR, Kim YS (1992) Transcriptional regulation of the human placental-like alkaline phosphatase gene and mechanisms involved in its induction by sodium butyrate. Cancer Res 52:3378–3383PubMedGoogle Scholar
  8. Frankel WL, Zhang W, Singh A, Klurfeld DM, Don S, Sakata T et al. (1994) Mediation of the trophic effects of short-chain fatty acids on the rat jejunum and colon. Gastroenterology 106:375–380PubMedGoogle Scholar
  9. Garnet L, Daviaud D, Denis-Pouxviel C, Remesy C, Murat J-C (1992) Effects of short-chain fatty acids on growth and differentiation of the human colon cancer cell line HT29. Int J Cancer 52:286–289CrossRefGoogle Scholar
  10. Hague A, Manning AM, Hanlon KA, Hutschtscha LI, Hart D, Paraskeva C (1993) Sodium butyrate induces apoptosis in human colonic tumour cell lines in a p53-independent pathway: implications for the possible role of dietary fibre in the prevention of large-bowel cancer. Int J Cancer 55:498–505PubMedCrossRefGoogle Scholar
  11. Harig JM, Soergel KH, Komorowski RA, Wood CM (1989) Treatment of diversion colitis with short-chain-fatty acid irrigation. N Engl J Med 320:23–28PubMedCrossRefGoogle Scholar
  12. Howe GR, Benito E, Castelleto R, Cornée J, Estève J, Gallagher RP et al. (1992) Dietary intake of fiber and decreased risk of cancers of the colon and rectum: evidence from the combined analysis of 13 case-control studies. J Natl Cancer Inst 84:1887–1896PubMedCrossRefGoogle Scholar
  13. Jenkins DJA, Wolever TMS, Taylor RH, Barker H, Fielden H, Baldwin JM et al. (1981) Glycemie index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr 34:362–366PubMedGoogle Scholar
  14. Kruh J, Tichonicky L, Defer N (1994) Effect of butyrate on gene expression. In: Binder HJ, Cummings JH, Soergel KH (Hrsg) Short Chain Fatty Acids. Dordrecht, Kluwer Academic Publishers, pp 135–147Google Scholar
  15. Macfarlane GT, Cummings JH (1991) The colonic flora, fermentation, and large bowel digestive function. In: The Large Intestine: Physiology, Pathophysiology, and Disease. Phillips SF, Pemberton JH, Shorter RG (Hrsg) New York, Raven Press, pp 51–91Google Scholar
  16. McIntyre A, Gibson PR, Young GP (1993) Butyrate production from dietary fibre and protection against large bowel cancer in a rat model. Gut 34:386–391PubMedCrossRefGoogle Scholar
  17. Potter JD (1992) Reconciling the epidemiology, physiology, and molecular biology of colon cancer. J Am Med Assoc 268:1573–1577CrossRefGoogle Scholar
  18. Roediger WEW (1980) Role of anaerobic bacteria in the metabolic welfare of the colonic mucosa in man. Gut 21:793–798PubMedCrossRefGoogle Scholar
  19. Roediger WEW (1990) The starved colon — diminished mucosal nutrition, diminished absorption, and colitis. Dis Colon Rect 33:858–862CrossRefGoogle Scholar
  20. Saini K, Steele G, Thomas P (1990) Induction of carcinoembryonic antigen-gene expression in human colorectal carcinoma by sodium butyrate. Biochem J 272:541–544PubMedGoogle Scholar
  21. Scheppach W, Fabian C, Ahrens F, Spengler M, Kasper H (1988) Effect of starch malabsorption on colonic function and metabolism in humans. Gastroenterology 95:1549–1555PubMedGoogle Scholar
  22. Scheppach W, Bartram P, Richter A, Richter F, Liepold H, Dusel G et al. (1992) Effect of short-chain fatty acids on the human colonic mucosa in vitro. J Parenter Enteral Nutr 16:43–48CrossRefGoogle Scholar
  23. Scheppach W, Sommer H, Kirchner T, Paganelli G-M, Bartram P, Christi S et al. (1992) Effect of butyrate enemas on the colonic mucosa in distal ulcerative colitis. Gastroenterology 103:51–56PubMedGoogle Scholar
  24. Scheppach W, Loges C, Bartram P, Christi SU, Richter F, Dusel G et al. (1994) Effect of free glutamine and alanylglutamine dipeptide on mucosal proliferation of the human ileum and colon. Gastroenterology 107:429–434PubMedGoogle Scholar
  25. Scheppach W, Bartram HP, Richter F (1995) Role of short-chain fatty acids in the prevention of colorectal cancer. Eur J Cancer 31A: 1077–1080PubMedCrossRefGoogle Scholar
  26. Scheppach W, and the German-Austrian SCFA study group (1996) Treatment of distal ulcerative colitis with short-chain fatty acid enemas: A placebo-controlled trial. Dig Dis Sci 41:2254–2259PubMedCrossRefGoogle Scholar
  27. Tremel H, Kienle B, Weilemann LS, Stehle P, Fürst P (1994) Glutamine dipeptide-supplemented parenteral nutrition maintains intestinal function in the critically ill. Gastroenterology 107:1595–1601PubMedGoogle Scholar
  28. Van der Hulst RRWJ, van Kreel BK, von Meyenfeldt MF, Brummer RJM, Arends JW, Deutz NEP et al. (1993) Glutamine and the preservation of gut integrity. Lancet 341:1363–1366PubMedCrossRefGoogle Scholar
  29. Vogelstein B, Fearon ER, Hamilton SR, Kern SE, Preisinger AC, Leppert M, et al. (1988) Genetic alterations during colorectal tumor development. N Engl J Med 319:525–532PubMedCrossRefGoogle Scholar
  30. Weber FL (1979) The effect of lactulose on urea metabolism and nitrogen excretion in cirrhotic patients. Gastroenterology 77:518–523PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1999

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