Background. Bowel-specific nutrient, glutamine, growth hormone, and modified diet have been reported to jointly improve nutrient absorption in patients with short bowel syndrome. However, controversy exists about the exact treatment factor. In this study we attempted to analyze the individual and combined effect of glutamine supplementation and growth hormone on small bowel adaptation by using tube feeding to control luminal nutrition supply. Materials and methods. Thirty-two adult male Sprague-Dawley rats (278 +/- 8 g) underwent 85% mid-small bowel resection and were randomly assigned to four groups: Control, receiving control liquid diet via a gastrotomy tube; GLN, receiving liquid diet enriched with 20 g. L(-1) glutamine; GH, receiving subcutaneous growth hormone (GH) (0.3 IU, bid); and GLN + GH, receiving both glutamine supplementation and GH treatment. All animals were provided with isocaloric (60 kcal/day) and isonitrogenous (0.686 g/day) nutrition. Absorption tests were performed in the form of oral nutrient tests with (14)C-labeled glucose and (3)H-labeled palmitic acid on the Postoperative Day 12. Results. GH treatment significantly increased the plasma insulin-like growth factor I (IGF-I) level, body weight, jejunal and ileal villous height and mucosal thickness, and peak plasma (14)C and (3)H levels. Glutamine supplementation did not produce a significant difference; however, combined with GH treatment, glutamine supplementation further increased body weight, plasma IGF-I level, jejunal and ileal villous height and mucosal thickness, and peak plasma (14)C and (3)H levels significantly. Conclusions. After massive small bowel resection, enteral glutamine supplementation alone has no remarkable beneficial effect on bowel adaptation. However, glutamine supplementation enhanced the gut-trophic effect of GH.
Copyright 2001 Academic Press.