摘要:

Dietary carbohydrate in the colon is fermented and converted into short-chain fatty acids. We studied the fate of carbohydrate that arrives in the colon under circumstances similar to those that occur during an episode of diarrhea and determined whether a quantitative correlation exists among certain indicators of colonic fermentation of carbohydrate arriving in the large bowel. A stable-isotope method was used to estimate carbon scavenging by the colon. Fourteen infants with severe malnutrition and history of watery stools and/or increased numbers of stools in the preceding 20 days were studied. Infants underwent nasocecal intubation and a 60-min infusion of 0.5 g/kg glucose containing 5 mg/kg of13C-glucose. Stools were assessed for carbohydrate-fermenting bacteria, acetate, glucose, and13C abundance; blood was assessed for acetate; and breath was assessed for hydrogen. Some of the infants eliminated the infusate per anus within 30 min of the infusion (group I; n = 5), while others did so 120 min or more after the infusion (Group II; n = 9). The volume of fecal output after the intracecal infusion differed significantly between group I and group II (57 ± 13 vs. 24 ± 4 ml; p < 0.05). Although baseline breath hydrogen (3 ± 1 vs. 10 ± 4 parts per million) and plasma acetate (41 ± 4 vs. 47 ± 9 μM) values were not significantly different between groups, breath hydrogen values at 45 min after start of infusion were significantly lower in group I than in group II (3 ± 1 vs. 19 ± 5 ppm; p = 0.008); 60 min after start of infusion, plasma acetate levels were significantly lower in group I than in group II (34 ± 8 vs. 69 ± 11μM; p = 0.02), and the difference remained significant throughout the study. Regression analyses indicated a significant association between time elapsed from start of intracolonic infusion and plasma acetate (p = 0.014) and breath hydrogen (p = 0.04) levels for group II. Although we found good correlation between two indicators of colonic fermentation, blood acetate and breath hydrogen, these values did not correlate well with carbon scavenging or fecal bacterial counts. It is possible that the way the colon handles the infusate—i.e., water absorption and/or secretion—may affect carbohydrate fermentation.

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The aim of this study was to investigate the feasibility of using applied potential tomography (APT), a noninvasive and nonradioactive method, to measure the rate of gastric emptying in preterm babies and infants <3 months old. APT, a form of electrical impedance tomography, creates tomographic images of tissue resistivity to a small electrical current and has been used to study gastric emptying in adults. The rate of gastric emptying of 53 preterm infants and 29 term infants was measured. The test feed was either milk (formula milk or expressed breast milk) or Dioralyte (a commercial rehydration solution). When a nasogastric tube was present, the results obtained by APT were validated by comparing the volume of feed estimated to be present with the volume that could be aspirated. All infants completed the investigation without any problems. APT demonstrated a slower rate of emptying of milk feeds than Dioralyte and showed that milk and Dioralyte feeds in preterm babies emptied at a similar rate to feeds in term infants. In validation studies, gastric emptying has been observed in 44 of 47 studies, and this finding was confirmed by aspiration of the nasogastric tube. Applied potential tomography is a safe, noninvasive method for measuring gastric emptying in small infants.

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Nonorganic failure to thrive (NOFTT) occurs in absence of any gastrointestinal, endocrine, or other chronic diseases. It is usually associated with psychosocial deprivation, although behavior problems may also contribute to its occurrence in absence of maternal pathology. We report seven infants and children between the ages of 13 and 30 months at the time of presentation, who failed to consume adequate calories and suffered from delayed growth. All were born at term after normal pregnancies with birth weights and lengths between the 50th and 95th percentiles except in one. None had any history of perinatal problems. Decreased intake was encountered almost immediately after birth, with lack of interest in consuming adequate calories. The evaluations performed did not reveal any specific etiology for the decreased intake. None had any developmental delay nor were there any psychiatric conditions in mothers. Changes in formulas or psychologic intervention were unsuccessful in modifying feeding habits except in two infants. All were supplemented with enteral supplements (Pediasure-five, Ensure-one, and Osmolite-one). Three did not consume enough orally and needed nasogastric tube infusions with eventual placement of gastrostomy tubes in two, and the third one has continued with nasogastric infusions. A significant increase in caloric intake caused improvement in growth percentiles. Height and weight percentiles improved in all and crept into the normal curve in four and five patients, respectively. Head circumference of two stayed at <5th percentile despite nutritional rehabilitation. Attempts at weaning off the supplements actually resulted in weight loss in all. Our data suggest that there is a critical need for early, aggressive nutritional intervention in such infants.

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

“Constipation” and “hard stools” are associated with formula feeding of both term and preterm infants and, in the latter, can lead to life-threatening complications. This study tested the hypothesis that stool hardness is related to excretion of fatty acid (FA) soaps in term infants, and in the extreme to milk bolus obstruction in premature infants. Stools (n = 44) were collected from 20 formula-fed and 10 breast-fed infants aged 6 weeks and were classified using visual charts for stool hardness on a 5-point scale (1, watery; 5, hard). Stools were analysed for nitrogen, minerals, and lipid, the latter divided between the soap and nonsoap fractions. We explored the relationship between stool hardness or solids content and stool constituents, relative to both wet and dry weight. Calcium and FA soaps were the dominant factors significantly related to stool solids and hardness score across the breast- and formula-fed groups. An 8% increase in stool dry weight FA soap content corresponded to a 1-point change in stool hardness score. Stools from formula-fed infants had a higher solids content and were classified as significantly harder than those from breastfed infants (hardness scores, 4.0 ± 0.5 versus 2.6 ± 0.7, mean ± SD) and on both a wet- and dry-weight basis contained severalfold higher levels of minerals and lipid and considerably less carbohydrate. Differences in lipids between formula- and breast-fed infants' stools were due almost entirely to FAs (mainly C16:0 and C18:0) excreted as soaps (27.7 ± 7.5% compared to 3.1 ± 4.1% of dry weight), suggesting the groups differed markedly in their handling of saturated FAs. An inspissated stool sample from a premature infant requiring surgical disempaction of an obstructed small intestine was found to be enriched in FA and calcium relative to the preterm formula. FA soaps, predominantly saturated, accounted for one third of the stool dry weight. These data support the hypothesis that calcium FA soaps are positively related to stool hardness; we speculate that this may, at least in part, explain the greater stool hardness in formula- versus breast-fed infants and milk bolus obstruction in preterm infants. This conclusion is consistent with the physical properties of calcium FA soaps.

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1995

数据来源: OVID