Effects of monomeric and polymeric diets on small intestine following massive resection.

Abstract

Since the introduction of long-term total parental nutrition, it has been possible to raise the survival rate in patients with massive intestinal resection. How to increase the remaining intestinal mucosa hyperplasia in these patients has become the focus of many studies. Early postoperative enteral feeding with exogenous intraluminal nutrition was considered to be one of the most essential factors. The best enteral food pattern, however, is still not conclusive. In this study, we used the animal model of rats with 60% small intestinal resection, giving them different kinds of enteral diets through gastrostomy tubes. The monomeric diet included amino acid, glucose, disaccharide, and triglyceride. The polymeric diet included the usual source of nutrition such as protein, polysaccharide, and fat. The rats were killed three weeks later. Histopathological changes of the remaining bowel and H3 thymidine incorporation to mucosal DNa were measured. We found: (1) hyperplasia of the remaining bowel in the 60% resected rats was definitely increased more than the rats of the sham operation; (2) from the protein content, the DNA content of mucosa cells, the villus height and crypt depth points of view, the polymeric diet fed rats had a better adaptation; (3) on the 21st postoperative day, the DNA synthetic rate was still very high in polymeric diet fed rats, but returned to preoperative levels in rats fed with a monomeric diet. Our conclusion of this study is that a polymeric diet can contribute to a better intestinal mucosa regeneration than a monomeric diet in the rats with massive intestinal resection.