Analysis of the effects of food and of digestive secretions on the small intestine of the rat: III. Mucosal mass, activity of brush border enzymes, and in vivo absorption of galactose, sodium, and potassium.

A modified Roux-en-y repositioning of rat proximal small intestine resulted in a gut segment (A) exposed only to digestive secretions, but not to food and a gut segment (B) exposed to food, stomach juice and by reflux only to digestive secretions, and a third segment (C) exposed to both, food and digestive secretions. The changes in segment A were qualitatively very similar to those occurring after removal of luminal nutrition (intravenous feeding, self-emptying blind loop, and Thiry Vella loop). These findings support the hypothesis that the presence of luminal nutrition is a major factor regulating mucosal mass and enzyme activity in rat proximal small intestine. The changes in the luminal environment in segment B caused an increase in mucosal mass (in the proximal half only), an increase in sucrase activity which paralleled the increase in mucosal mass, and no change in activity of alkaline phosphatase which in fact was a decrease in activity ;at the cellular level'. Later on the net absorption of sodium and potassium was improved and the disappearance of galactose was unchanged when referred to unit length of small intestine.In segment C there was a small increase in mucosal mass, an increase in activity only for alkaline phosphatase, and an improvement of the net absorption of sodium without changes in the disappearance of galactose. These changes were compatible with a more proximal promotion of a distal gut segment.

[Influence of duodenal reflux on the epithelium of the gastroenteral anastomosis (author's transl)]. / Der Einfluss des duodenogastrischen Refluxes auf das Epithel an der gastroenteralen Anastomose. Eine experimentelle Untersuchung.

The cancerogenic effect of continous duodenal reflux on the gastric mucosa has been investigated in male Wistar-rats after gastrointestinal anastomosis. Groups of animals with gastroenterostomy without enteroenteral anastomosis and with Roux-en-y-anastomosis preventing duodenal reflux were treated with lower dosages of the cancerogenic Nitrosoguanidine. Proliferative mucosal alterations near the gastroenteral anastomosis were observed. In addition the gastric mucosa was characterized by adenomatous lesions caused by duodenal reflux. The changes detected were not influenced by Nitrosoguanidine and did not appear in cases of Roux-en-y-anastomosis.

[Bacterial flora and nitrite production in the stomach after gastroenterostomy. Experimental aspects of the pathogenesis of carcinoma in the operated stomach (author's transl)]. / Bakterielle Besiedlung und Nitritbildung im Magen nach Gastroenterostomie. Experimentelle Aspekte zur Pathogenese des Carcinoms im operierten Magen.

A gastroenterostomy without enteroanastomosis leads to a change in the bacterial flora of the stomach, where-by in particular the proportion of nitrite-decomposing bacteria, is enhanced. This results in an increase of nitrite concentration in the gastric fluid, which may possibly be accompanied by an augmented production of carcinogenic nitrosoamine. This latter aspect is considered with respect to the origin of carcinoma in the operated stomach. Since the reported changes will be largely prevented by a Roux-Y-gastroenterostomy, this should be taken into consideration for reconstruction of the alimentary tract after gastric surgery.

An experimental model for studies on the effects of food and digestive secretions on the digestive-absorptive capacity of rat small intestine.

At an average of 32 days after a modified Roux-en-y repositioning of rat small intestine, the mucosal mass, mucosal composition, in vivo absorption of galactose and the activity of maltase, sucrase and alkaline phosphatase were measured. In the gut segment with digestive secretions but without food (A) the only change was a decrease of sucrase activity which occurred most probably at the cellular level. In the gut segment with food and gastric juice and a reflux of digestive secretions (B) complex changes took place. An increase in mucosal mass was not accompanied by an increase in galactose absorption. There was a high increase of sucrase activity, a moderate increase of maltase activity and a tendency of the alkaline phosphatase activity to decrease. The changes (increase in mucosal mass and total enzyme activity, but no changes in activity at the cellular level) in the segment exposed to both digestive secretions and food (C) were compatible with a more proximal promotion of a distal gut segment.

Analysis of the effects of food and of digestive secretions on the small intestine of the rat. 1. Mucosal morphology and epithelial replacement.

A modified Roux-en-Y repositioning of rat small intestine was performed so that the proximal segment of bowel (A) received only bile and pancreastic secretions, the second (B) received food direct from the stomach, and these two segments drained into a third (C). Four to five weeks after operation, cell production was assessed by injection of vincristine into operated, sham-operated and unoperated rats, and counts of blocked metaphases were made on isolated microdissected crypts. Villus height, crypt depth, and the number of crypts per villus (crypt/villus ratio) were also measured. Most of segment A showed no significant differences from sham-operated intestine, although the normal proximo-distal gradient of villus height was abolished. At the distal end (near the anastomosis with segments B and C), crypt depth and cell production were increased. The villus height gradient in segment B was also abolished, although crypt depth and cell production were significantly increased, especially at the proximal end. Crypt/villus ratio was also increased. Segment C showed all the characteristics of small bowel promoted to a more proximal position: increased villus height, crypt depth and cell production. Increased crypt/villus ratio was also observed. These results are discussed in terms of the role of food and of digestive secretions in the control of mucosal morphology and epithelial replacement.