In order to examine the postprandial blood concentrations of insulin-independent carbohydrates after gastric surgery oral galactose test (1.65 g/kg body weight in water, 33%, w/v) was performed in 55 symptomatic patients and in 5 healthy subjects. There were patients after total gastrectomy (TG) (n = 17), gastric resection with (GRS, n = 17) or without (GR; n = 12) selective vagotomy, and after proximal selective vagotomy (PSV, n = 9). The patients had immediately after drinking the test solution a 2- to 5-fold higher blood galactose concentration than the healthy subjects. The TG patients had the most rapid, the healthy subjects the slowest and the GR and GRS patients an intermediate rapid, immediate increase of blood galactose concentration. The TG patients showed a plateau 40-60 min and a decrease 60-90 min after the start of the test. The PSV patients showed a plateau 60-90 min after the commencement of the test. The GR and GRS patients and the healthy subjects had a continuous increase in blood galactose concentration during the whole test period, but the maximal point 90 min after the drinking of the solution was lower in the GRS than in the GR patients and lowest in the healthy subjects. The PSV patients had a lower blood galactose curve than the TG, GRS and GR patients but higher than the healthy subjects except the plateau 60-90 min postprandially.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomotic healing 100 Antioxidant therapy 141 Arterial ketone body ratio 170 Bile acid(s) 151.285 -secretion 151 Bioerodible polyorthoester 45 Blastogenesis 9 Bone wax 45 Breaking strength 235 Carbon fibre 35 Centripetal pump-driven active bypass 170

Intestinal absorption was examined using an oral galactose test in colon interposition patients with dumping (no. 4) and without symptoms (no. 5). Normal subjects (no. 5), and patients after total gastrectomy (no. 7) and gastric resection (no. 4) served as controls. Galactose is absorbed in the same way as glucose, but does not stimulate insulin secretion. Colon interposition patients presented abnormally rapid postprandial transit and absorption for 20 minutes after the meal. After this rapid phase, colon interposition patients with dumping demonstrated a strong decrease in absorption rate, whereas the asymptomatic patients presented a normal rate during the whole follow-up period. The elimination of galactose from the blood was studied in eight patients after intravenous infusion of galactose; the disappearance was linear during 10 to 30 min after injection and did not explain the differences in blood galactose levels in the oral galactose test. We suggest a reactive reflux back to the intra-abdominal colon graft loop in the avagotonic intestinal tract as the mechanism for the differences in absorption. The most likely reason for this is the rapid initial phase transit through the coloantral anastomosis and pyloroplasty. To normalize postprandial transit and absorption as much as possible after colon interposition, a short intra-abdominal colon graft loop anastomosed to the posterior proximal stomach is suggested.