Intestinal adaptation following gut resection

Czech version

Authors: Jarmila Křížová; Pavel Trachta; Eva Kotrlíková
Authors‘ workplace: III. interní klinika 1. LF UK a VFN v Praze
Published in: Vnitř Lék 2017; 63(10): 703-706
Category: Reviews

Overview

Gut resection is followed by wide changes in the gastrointestinal tract. The goal is to increase nutrient, water and mineral absorption in the remnant intestine. These changes are going on for several months. They affect gut mucosa structure, intestine peristaltic activity and enterocytes function. The crucial role is ileum preserving. Ileum has higher adaptation ability comparing to jejunum and inhibits peristaltic function of proximal parts of GIT. A lot of factors involved in intestinal adaptation were identified, hormones, growth factors, regulating peptides, intracellular signalizing cascades, cytokines and tissue factors. The most important seems to be GLP2 (glucagon like peptide 2) which has positive trophic influence on gut mucosa. Early enteral nutrition after gut resection enhances its adaptation. Recombinant analogueGLP2 teduglutide was introduced to be used in the short bowel syndrome treatment. It inhibits stomach evacuation and hypersecretion, increases intestine perfusion and enhances intestinal adaptation. Its long-term application accelerates the parenteral nutrition weaning.

Key words:
enteral nutrition – enterocytes – GLP2 – gut resection – intestinal adaptation

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