lead to a stabilisation or even an improvement of the bone mineral density (BMD) on the long range. Methods: Retrospective study of patients under HPN followed by the Gastroenterology Service of St-Luc Hospital from 2004 to 2011. Exclusion criteria were the lack of data on BMD or the absence of an osteodensitometry at the beginning of the HPN. Follow-up included regular visits with an endocrinologist, an initial dual energy X-ray absorptiometry at the start of HPN and every two years thereafter. BMD at the hip (g/cm2) were collected and their evolution was measured. A reduction or an increase in BMD was considered significant for a drop or a rise of 0.04 g/cm2 respectively. Results: 44 patients under HPN were identified. Data on BMD were collected for 30 individuals. A mean of 4 dual energy X-ray absorptiometry were performed for each patient. On average, we observed a drop of 0.01 g/cm2 (95% confidence interval (CI); drop of 0.03 rise of 0.01 g/cm2) in BMD for the entire follow-up. Globally, more than 70% of individuals showed a stabilisation or an increase in their BMD on the long range. It looks like there was no difference in the evolution of the bone status between people with osteoporosis initially and those without osteoporosis at the beginning of HPN. In addition, a small waiting time between the diagnosis of intestinal insufficiency and the beginning of HPN seems to ensure a better constancy of the BMD (odds ratio: 5.8; P value = 0.19). This trend seems similar when the duration of HPN was short (odds ratio: 4.5; P value = 0.16). Conclusion: An adequate follow-up of patients under HPN ensures a stabilisation of BMD on the long range.

1. Occurrence of short chain fatty acids (SCFA) in anionic form limits their diffusion across the absorptive membrane. The present study sought to establish the mechanism of SCFA absorption in the ostrich. 2. Epithelial tissues were taken from the sacculated part of the colon and mounted in Ussing chambers in a bathing solution. The tissues were voltage-clamped and allowed to equilibrate to obtain a baseline short circuit current (Isc). 3. Propionate (23 mM) on the mucosal side increased the Isc. The SCFA-induced Isc was completely inhibited by anoxia, ouabain (1 to 2 mM), acetazolamide (0.5 mM) and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (0.1 mM) on the mucosal side. 4. These findings indicate that SCFA stimulate hydrogen ion secretion through an electrogenic H(+)-K(+)-ATPase, the source of hydrogen ions being carbonic anhydrase catalysed hydration of CO2. 5. Simultaneous activation of Cl(-)/HCO3(-) exchange prevents intracellular accumulation of bicarbonate ions. This system may provide hydrogen ions for protonation of SCFA anions and subsequent absorption by non-ionic diffusion.

The colon is a major site for fermentation and water absorption in the ostrich. Water absorption along the colon was evaluated and its relationship to osmolality, Na+ concentration, short chain fatty acid (SCFA) concentration and carbohydrate content of digesta analysed. Mean water content decreased from 5.30 +/- 0.99 to 2.51 +/- 0.13 mf/g dry mass in the first 5 m of the colon. Correspondingly, mean carbohydrate content fell from 529.85 +/- 46.61 to 434.99 +/- 29.89 mg/g dry mass. A significant correlation was shown between the decreases in mean carbohydrate and water content along the colon (r2 = 0.997, P < 0.05). Changes in mean osmolality (+/- 10 mOsm/kg) and SCFA concentration (+/- 7 mmol/l) were minimal in comparison to the change in Na+ concentration (-54 mmol/l). These findings reflect a close coupling between SCFA production and absorption on the one hand and water absorption on the other.

Background: Current knowledge on the colonorectal absorption of medium-chain fatty acids is limited. The purpose of the present study was to evaluate and compare the human rectal absorption of short-and medium-chain C(2)-C(10) fatty acids in healthy volunteers. Methods: Dialysis bags containing 20 mmol.l(-1) of the fatty acids acetate, butyrate, hexanoate, octanoate, or decanoate in a phosphate-buffered (pH neutral) isoosmotic electrolyte solution were placed in the rectum for 30 min in 14 healthy volunteers. Absorption rates were calculated for all fatty acids, sodium, potassium, and water. Results: Absorption rates of the fatty acids acetate, butyrate, hexanoate, octanoate or decanoate were the same (1.9 +/- 0.1 = 2.5 +/- 0.2 = 1.7 +/- 0.2 = 1.9 +/- 0.2 = 2.2 +/- 0.1 mu mol.cm(-1).h(-1) (mean +/- standard error of the mean), respectively; P=0.24). Conclusions: Medium-chain fatty acids were absorbed in the human rectum at a rate similar to that for short-chain fatty acids. If results can be applied to the human colon, colonic absorption of medium-chain fatty acids could possibly became an important secondary site of absorption in abnormal intestinal conditions such as massive small-intestinal resection or malabsorption syndromes.

Developmental changes in intestinal function occur in the perinatal period of many species. We investigated the hypothesis that gestational age at delivery and the mode of delivery influence intestinal function. Newborn pigs (106–108 or 113–115 days gestation, term = 115 ± 2 days) were either delivered by caesarean section or born vaginally following induction of parturition with a prostaglandin F2α analogue. The pigs were killed at birth and used for measurements of intestinal ion transport in vitro (using Ussing chambers) or killed at 2 days of age, after being fed porcine colostrum to follow the absorption of intact proteins into plasma. The results indicate that premature birth is associated with increased paracellular permeability to ions. The uptake and net absorption of chloride were higher in the term, vaginally-delivered pigs than in the remaining pigs. Among the newborn pigs, the preterm caesarean-delivered pigs exhibited the lowest chloride secretion in response to the secretagogue, theophylline. The latter pigs also absorbed the lowest amounts of immunoglobulin G and albumin from colostrum. In conclusion, gestational age at delivery and the mode of delivery have significant effects on intestinal transport of ions and intact proteins. However, the observed variation in the magnitude and the direction of responses indicate that (a) prematurity and birth influence the transport of ions and intact proteins through independent regulatory mechanisms and (b) the absorption pathways for ions and intact proteins in the neonatal pig intestine are not closely associated.

A major advance in transport physiology was H. H. Ussing's development of the voltage-clamp method, and later the Koefoed-Johnsen-Ussing model for Na+ transport. In the same decade, J. C. Skou identified the Na+-K+-ATPase, which maintains the Na+ and K+ gradients that drive most epithelial transport processes. With this foundation, Danish scientists have pursued the mechanism of ion transport and the resulting solute-linked water flow. Recent contributions have been on isosmotic transport, suggesting solute recycling, and KCl-water cotransport in the basolateral epithelial cell membrane. Efficient small intestinal nutrient absorption is dependent on coupling to the Na+ gradient. Cotransport of Na+ and glucose is quantitatively the most important absorptive mechanism in the small intestine, as illustrated by the success of oral rehydration solutions in diarrhoea. The majority of amino acids are likewise transported by Na+ dependent carriers, but recent experiments have identified a concomitant Cl- dependency for some. Regulation of intestinal secretion, both under normal digestive processes, and in response to enterotoxins, has turned out to be very complex. It involves local and central neuronal regulation through an array of neurotransmitters and local actions of gastrointestinal hormones. Major effectors are the submucosal neurons and the main transmitters serotonin, vasoactive intestinal peptide, acetylcholine, substance P, and neurotensin. Development of antisecretagogues is impeded by the existence of several receptor subtypes and significant species differences. The Na+ and water-conserving properties of the large intestine have been shown to be regulated by adrenocortical hormones, with aldosterone as a potent stimulator of colonic Na+ absorption. A major colonic function is the symbiosis with the anaerobic bacterial population. The fermentation of carbohydrate to short-chain fatty acids, which can be absorbed, supplements small intestinal digestive function.

BACKGROUND:Models of short-chain fatty acid absorption have focused on the stimulation of sodium absorption, an effect mainly located in the proximal colon of man. With the present efforts to utilize butyrate enemas as a treatment of ulcerative colitis, it seemed important to assess the transport in the rectum.METHODS:Non-equilibrium dialysis of the rectum was applied by placing dialysis bags containing various electrolyte solutions in the rectum of volunteers for 30 min. In this period changes in ion concentrations were linear with time. Net absorption and secretion rates were calculated from the change in fluid composition.RESULTS:Sodium absorption was highest (24 +/- 8 mumol/cm2 h) in the presence of chloride and lowest (16 +/- 2 mumol/cm2 h) in the presence of bicarbonate and butyrate. Butyrate (70 mmol/l) was absorbed at a high rate of 7.1 +/- 2.2 mumol/cm2 h, independent on the presence of chloride, and was accompanied by increased bicarbonate secretion. Butyrate absorption increased to 9.6 +/- 1.8 mumol/cm2 h in sodium-free high-potassium media containing bicarbonate.CONCLUSION:The results show that it is possible to increase butyrate uptake by manipulation of the electrolyte composition in the rectal lumen. Maximal uptake occurred with an electrolyte composition that was similar to the natural rectal content. The information gathered could be useful in designing enemas for trial in ulcerative colitis, provided the findings can be confirmed in these patients.

Experiments were performed on isolated, stripped colonic epithelia of low-salt-adapted hens (Gallus domesticus) in order to characterize acid secretion by this tissue. With symmetric, weak buffer solutions, colonic epithelia acidified both mucosal and serosal sides. Titration measurements of the mucosal acidification rate (pH-stat technique) averaged 1.63±0.25 μEq·cm-2·h-1. Mucosal acidification was also evident in colons from high-salt-adapted birds and in low-salt-adapted coprodeum, but was completely abolished in the high-salt coprodeum. Mucosal acidification by low-salt-adapted colonic epithelium was unaffected by sodium replacement, mucosal amiloride (10-3 mol·l-1), and serosal ouabain (5x10-4 mol·l-1), although all three treatments significantly reduced or reversed the short-circuit current. Acetazolamide (10-3 mol·l-1, serosal) reduced mucosal acidification by 15% and simultaneously increased short-circuit current by a similar amount. Colonic epithelia incubated in glucose-free solutions had significantly lower acidification rates (0.59±0.13 μEq·cm-2·h-1, P<0.002 versus controls) and addition of glucose (15 mmol·l-1), but not galactose, partially restored acidification to control levels. Anoxia (N2 gassing) completely inhibited short-circuit current, but reduced acidification by only 30%. A surface microclimate pH, nearly 2 pH units more acidic than the bath pH of 7.1–7.4 was measured in low-salt-adapted colon and coprodeum. The acid microclimate of both tissues was partially attenuated by adaptation to a high-salt diet. Colonic microclimate pH was dependent on the presence of glucose and sensitive to the bath pH. Histochemical staining for carbonic anhydrase localized this enzyme to cytoplasm and lateral margins of one subfraction of colonic cells, and to cytoplasm in a second subpopulation Intense staining was also evident in subepithelial capillaries. These results suggest that a large part of mucosal acidification and maintenance of the acid microclimate in hen colon may be dependent on glycolysis and metabolic acid production, although a smaller, electrogenic and acetazolamidesensitive component also appears to exist. This latter component may become more prominent under conditions of cellular acidification.

Short chain fatty acids (SCFAs) are potentially valuable as a topical therapy for distal ulcerative colitis. The mechanism of action is unknown but may involve improved intracellular energy production as previous evidence indicates that colonocyte oxidation of butyrate is impaired in ulcerative colitis. No information is, however, available on human mucosal metabolism of acetate and propionate in either health or disease or the Vmax and Km values of butyrate oxidation. The aim of the study was to assess the kinetic parameters, Vmax and Km, of the complete oxidation of short chain fatty acids and glucose by human colonocytes and to explore whether a metabolic abnormality could be confirmed in patients with ulcerative colitis. Colonocytes were isolated from surgical specimens obtained from 14 patients with ulcerative colitis and eight control subjects. Incubations were performed in the presence of a concentration range of 14C-labelled acetate, propionate butyrate, and glucose. Oxidation rates were obtained by quantifying the production of 14CO2. Vmax and Km were calculated by computer fitting of the data to a Michaelis-Menten plot. No significant differences were shown in either Vmax or Km values of any of the SCFAs or glucose comparing controls and patients with ulcerative colitis. Comparing the results obtained regarding the individual SCFAs, the most striking difference was the considerably lower Km value of butyrate. The apparent Vmax of acetate tended to be higher than Vmax of propionate and butyrate. Vmax of glucose oxidation was significantly lower compared with the Vmax values of SCFA oxidation. The study shows the ability of isolated human colonocytes to utilise each of the three major SCFAs, but does not support a pathogenic role for defective metabolism of butyrate in ulcerative colitis. The considerably lower Km of butyrate oxidation supports a specific role of butyrate as an energy source for the colonic mucosa in both health and ulcerative colitis.