Tributyrin Supplementation Protects Immune Responses and Vasculature and Reduces Oxidative Stress in the Proximal Colon of Mice Exposed to Chronic-Binge Ethanol Feeding.

Excessive ethanol consumption causes adverse effects and contributes to organ dysfunction. Ethanol metabolism triggers oxidative stress, altered immune function, and gut dysbiosis. The gut microbiome is known to contribute to the maintenance of intestinal homeostasis, and disturbances are associated with pathology. A consequence of gut dysbiosis is also alterations in its metabolic and fermentation byproducts. The gut microbiota ferments undigested dietary polysaccharides to yield short-chain fatty acids, predominantly acetate, propionate, and butyrate. Butyrate has many biological mechanisms of action including anti-inflammatory and immunoprotective effects, and its depletion is associated with intestinal injury. We previously showed that butyrate protects gut-liver injury during ethanol exposure. While the intestine is the largest immune organ in the body, little is known regarding the effects of ethanol on intestinal immune function. This work is aimed at investigating the effects of butyrate supplementation, in the form of the structured triglyceride tributyrin, on intestinal innate immune responses and oxidative stress following chronic-binge ethanol exposure in mice. Our work suggests that tributyrin supplementation preserved immune responses and reduced oxidative stress in the proximal colon during chronic-binge ethanol exposure. Our results also indicate a possible involvement of tributyrin in maintaining the integrity of intestinal villi vasculature disrupted by chronic-binge ethanol exposure.

The clear liquid diet is no longer a necessity in the routine postoperative management of surgical patients.

The reinstitution of oral intake in patients who have undergone intra-abdominal surgery has traditionally progressed in a stepwise fashion. Various retrospective studies and anecdotal reports have suggested that a "regular" diet as the first postoperative meal is well tolerated. Although clear liquids are accepted as the standard first postoperative meal, there appears to be little scientific data to support their use. The current study was undertaken to determine whether there is any difference in tolerance to clear liquids versus a regular diet as the first postoperative oral intake. This study is not intended to suggest that clear liquid diets harm patients but to attempt to support our hypothesis that a regular diet as the first postoperative meal is not associated with and increased morbidity. A total of 241 patients undergoing abdominal operations were prospectively randomized to receive either routine clear liquids (N=135) or regular diet (N=106) as the first oral intake. They were followed for any symptoms or signs of dietary intolerance. The group receiving a regular diet was not found to have any statistically significant increase in dietary intolerance in comparison with the clear liquid group. Nutritional data collected in a subset of patients revealed a higher caloric intake in those assigned to a regular diet. These results suggest that the routine use of clear liquids as the initial postoperative diet may be unnecessary and nutritionally suboptimal when compared with a regular diet.