Intestinal transport during fasting and malnutrition

Annu Rev Nutr. 2000;20:195-219. doi: 10.1146/annurev.nutr.20.1.195.


Fasting or malnutrition (FM) has dramatic effects on small intestinal mucosal structure and transport function. Intestinal secretion of ions and fluid is increased by FM both under basal conditions and in response to secretory agonists. Intestinal permeability to ions and macromolecules may also be elevated by FM, which increases the potential for fluid and electrolyte losses and for anaphylactic responses to luminal antigens. Mucosal atrophy induced by FM reduces total intestinal absorption of nutrients, but nutrient absorption normalized to mucosal mass may actually be enhanced by a variety of mechanisms, including increased transporter gene expression, electrochemical gradients, and ratio of mature to immature cells. These observations underscore the value of enteral feeding during health and disease.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Biological Transport
  • Energy Intake / physiology
  • Fasting / physiology*
  • Humans
  • Intestinal Absorption / physiology*
  • Intestinal Mucosa / metabolism*
  • Intestinal Mucosa / physiology
  • Intestine, Small / metabolism*
  • Intestine, Small / physiology
  • Nutrition Disorders / metabolism*
  • Nutrition Disorders / physiopathology
  • Permeability
  • Water-Electrolyte Balance