Small-intestinal digestion of partially resistant cornstarch in healthy subjects.

The aims of this study were to measure the amount of starch from partially resistant starches (retrograded and complexed high-amylose cornstarches) escaping small-intestinal digestion in healthy humans by use of an intubation method and to compare these data with data obtained by indirect in vitro methods. Experiments were carried out in vivo in 6 healthy humans by using ileal intubation and stool analysis and in vitro by using 3 different methods for analyzing resistant starch. In intubated subjects, 51 +/- 2% of the retrograded and 21 +/- 2% of the complexed starch was delivered to the ileum and was fermented almost completely in the colon. In vitro estimates of the absorption of resistant starch were much lower. We conclude that technologically modified starches may substantially increase the amount of carbohydrate available for colonic fermentation in humans, but that in vitro measurements of resistant starch are inaccurate for predicting malabsorption in healthy humans.

Digestion of carbohydrate from white beans (Phaseolus vulgaris L.) in healthy humans.

Resistant starch (RS) is thought to be present in large amounts in legume seeds; however, it has never been quantified in healthy humans. RS from cooked (atmospheric pressure) white beans was quantified in humans and pigs, and characterized to explain its low digestibility. Six human volunteers were intubated to collect ileal digesta after an experimental meal composed of orange juice, butter and 167 g beans (dry matter basis). The reliability of the intubation method was examined in a pig study in which it was compared with another collection method, ileal cannulation. Chemical analyses, microscopy and size exclusion chromatography were performed on human and pig digesta. The pig study showed that the intubation method may underestimate the quantity of RS. However, no chemical/physical difference was observed between the RS collected by the two techniques. In the human study, 16.5 +/- 1.3% (11.3 g) of the ingested starch was recovered as RS. The microscopy of the digesta showed that part of the RS was enclosed in the cell walls. Although the RS was composed mainly of alpha-glucan molecules with a degree of polymerization (DP) 40 to 60, oligosaccharides and large molecules of DP > 400 were also present. Retrogradation was not found to be the main factor responsible for starch malabsorption. We conclude that white beans may contain a large amount of RS formed mainly by partially degraded molecules protected by the cell walls during their transit through the gut.

Peptide YY inhibition of prostaglandin-induced intestinal secretion is haloperidol-sensitive in humans.

BACKGROUND & AIMS: It is uncertain whether peptide YY (PYY) inhibits human intestinal secretion directly through enterocyte receptors or via indirect neural mechanisms. Thus, the effect of PYY on prostaglandin E2 (PGE2)-induced jejunal secretion in normal volunteers was measured, and it was determined whether a dopamine and sigma antagonist affected PYY effect. METHODS: Jejunal absorption of water and electrolytes was measured by a perfusion method in 6 volunteers. A double-blind crossover study was performed, involving intraluminal infusion of PGE2, intravenous infusion of human PYY, and intramuscular injection of haloperidol or placebo. RESULTS: PGE2 induced net secretion of water and electrolytes (P < 0.01 vs. basal). The effect of PGE2 was reduced by about half with 30 pmol x kg(-1) x h(-1) of PYY (plasma PYY, 96 +/- 12 pg/mL) and suppressed by 90 pmol x kg(-1) x h(-1) of PYY (P < 0.01; plasma PYY, 268 +/- 22 pg/mL). Plasma PYY was correlated negatively (P < 0.01) with net fluxes of water, Cl-, Na+, and K+. Haloperidol suppressed the effect of PYY on PGE2-induced secretion (P < 0.05). CONCLUSIONS: PYY administered in doses producing slightly supraphysiological plasma levels inhibits PGE2-induced secretion in normal humans. Sigma or dopamine receptors (probably neuronal ones) are involved in this effect.

Digestion, excretion, and energy value of fructooligosaccharides in healthy humans.

The fate of fructooligosaccharides (FOS) in the human gastrointestinal tract was evaluated in six healthy volunteers over an 11-d period. After an equilibration phase, 20.1 g FOS/d was given in three identical postprandial doses. Distal ileal output of FOS and their constituent components were determined by intestinal aspiration after a single meal, and the amounts of FOS excreted in stools and urine were also measured. Most of ingested FOS, 89 +/- 8.3% (mean +/- SEM), was not absorbed in the small intestine, and none was excreted in stools, indicating that the portion reaching the colon was completely fermented by colonic flora. A small fraction of ingested FOS was recovered in urine. The mean estimated energy value of FOS was 9.5 kJ/g. We conclude that in healthy humans, FOS are only slightly digested in the small intestine and then fermented in the colon, resulting in reduced energy production.

Digestion of raw banana starch in the small intestine of healthy humans: structural features of resistant starch.

The digestion of freeze-dried green banana flour in the upper gut was studied by an intubation technique in six healthy subjects over a 14 h period. Of alpha-glucans ingested, 83.7% reached the terminal ileum but were almost totally fermented in the colon. Structural study of the resistant fraction showed that a small part of the alpha-glucans which escaped digestion in the small intestine was composed of oligosaccharides from starch hydrolysis, whereas the rest was insoluble starch in granule form with physical characteristics similar to those of raw banana starch. Passage through the small intestine altered granule structure by increasing susceptibility to further alpha-amylase hydrolysis. Compared with resistant starch values in vivo, those obtained with the in vitro methods tested were inadequate to estimate the whole fraction of starch reaching the terminal ileum.

Role of viscous guar gums in lowering the glycemic response after a solid meal.

The aim of the present study was to investigate how guar gum viscosity acts on starch digestion and glucose absorption in humans. Six healthy subjects received a mixed diet composed of 60.4% carbohydrate in the form of maize glucose or pregelatinized starch, to which was added 5.6% low- or high-viscosity guar gums. Meals were ingested or instilled in the duodenum and postprandial insulin and glucose responses were monitored for 3 h. Infusion of meals containing glucose showed that the delay in the diffusion rate to the duodenal mucosa due to bolus viscosity was not significant. Infusion of meals containing starch showed that a decrease in the digestion rate of starch in the upper small intestine accounted for part of the effect of viscosity on glycemic response, whereas the main effect of guar gum was apparently to slow gastric emptying.

Structural features of resistant starch at the end of the human small intestine.

Structural features of in vivo resistant starch were assessed using the ileal contents of four humans. Two of the latter were collected by ileostomy after ingestion of bean flakes or potato flakes and the other two were collected by an intubation technique after ingestion of retrograded high-amylose maize starch or complexed high-amylose maize starch. The degree of polymerizations (DP), solubility and crystallinity were assessed. For all samples, starch fractions which escaped digestion in the small intestine were composed of three populations of alpha-glucans with proportions differing according to the substrate. Small quantities of oligosaccharides made up the first population, illustrating a limitation of absorption in the small intestine. The second population, the main resistant fraction, was comprised of retrograded amylose of mean DPn of about 35 glucose units with a melting temperature at 150 degrees C and exhibiting a B-type pattern. Finally high molecular weight semi-crystalline alpha-glucans were attributed to fragments of starch. This study showed that some potentially digestible starch could reach the colon and crystalline fractions constituted only part of the starch that escaped digestion in the human small intestine.

Fate of beta-cyclodextrin in the human intestine.

We assessed the fate of beta-cyclodextrin, which is composed of seven alpha(1-->4)-linked glucose units in ring structure, in the human gastrointestinal tract. In four healthy ileostomists, ileal effluent was collected after oral administration of beta-cyclodextrin during fasting (10 g of beta-cyclodextrin) and postprandially (10 g of beta-cyclodextrin three times daily with meals). In 10 healthy volunteers, the amount of beta-cyclodextrin passing into the colon was determined by means of the breath hydrogen technique using lactulose as a standard, and stools were collected after oral administration of beta-cyclodextrin during fasting (10 g of beta-cyclodextrin) and postprandially (10 g of beta-cyclodextrin three times daily with meals). In ileostomists, we recovered from the small intestine 91 +/- 5% and 97 +/- 10% (mean +/- SD) of beta-cyclodextrin ingested during fasting and with meals, respectively. In healthy volunteers, H2 excretion in breath after beta-cyclodextrin ingestion was low compared with excretion after lactulose, but only traces of beta-cyclodextrin were recovered in stools. We conclude that beta-cyclodextrin is poorly hydrolyzed in the human small intestine but that it is fermented by the colonic flora with apparent minimal H2 production.

Antineutrophil cytoplasmic auto-antibodies in sera from patients with ulcerative colitis after proctocolectomy with ileo-anal anastomosis.

Presence of antineutrophil cytoplasmic auto-antibodies (ANCA) in ulcerative colitis could be an epiphenomenon related to colonic inflammation and/or may reflect a primitive disturbance of immune regulation. In this regard, study of ANCA status after the whole colorectal mucosa has been removed could favor one of these two hypothesis. We compared the prevalence of ANCA in a first group of 70 patients with non operated UC and in a second group of 32 patients with UC having had a proctocolectomy with ileoanal anastomosis. Perinuclear ANCA (p-ANCA) were found in 34/70 (49%) of the first group as compared to 11/32 (34%) in the second group (NS). Our results further support that the presence of ANCA in UC reflects an immune disturbance not linked to the presence of the target organ.