Small bowel resections--exhaustive approach to a theory of adaptation

• Published in: World review of nutrition and dietetics Vol. 23; pp. 1 - 224
• Main Author: Laplace, Jean-Paul
• Format: Journal Article
• Language: English
• Published: Switzerland 1975
• Subjects: adaptation; Adaptation, Physiological; anatomy and morphology; Anemia - etiology; Animals; behavior modification; Bile - physiology; Colon - physiology; Colon - transplantation; Diet; Digestion; Digestion and absorption; digestive system diseases; Female; Gastrointestinal Motility; gastrointestinal system; Growth; Humans; Hypercholesterolemia - therapy; Intestinal Absorption; Intestinal bypass surgery; Intestinal Mucosa - anatomy & histology; Intestinal Secretions - physiology; Intestine, Small - enzymology; Intestine, Small - microbiology; Intestine, Small - physiology; Intestine, Small - surgery; Intestine, Small - transplantation; Intubation, Gastrointestinal; Male; Medical factors; nutrition assessment; Obesity - therapy; Parenteral Nutrition; Postoperative Complications - therapy; Pregnancy; risk factors; Stomach - physiology; Transplantation, Autologous
• ISSN: 0084-2230; 1662-3975

A detailed review is provided of the effects of enterectomies and various surgical procedures leading to functional isolation in situ of a small intestine segment, with emphasis on the various physiological and nutritional consequences of small intestinal resection (or exclusion). Elements addressed include: survival and growth; bowel morphology and motility; various absorption phenomena; digestive secretions and gastrointestinal flora; and blood constants and metabolic effects related to nutritional deficiencies. An attempt was made to collect analogical elements for interpretation of these phenomena. Some of the relations between digestive ability and feeding behavior were considered, as well as the principal digestive changes resulting from feeding variations or during reproduction. The surgical impairment of the digestive ability was assessed and a critical evaluation was made of available clinical and experimental data. Finally, integration of the morphological and functional data led to a proposition of a dynamic equilibrium among 3 elements and reconciliation with a theory of harmonic maintenance, leading to a general interpretation of the adaptation processes. (wz)