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Calcium absorption following small bowel resection in man. Evidence for an adaptive response
Author(s) -
COLETTE C.,
GOUTTEBEL M. C.,
MONNIER L. H.,
SAINTAUBERT B.,
JOYEUX H.
Publication year - 1986
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1986.tb01341.x
Subject(s) - calcium , gastroenterology , medicine , calcium metabolism , positive correlation , resection , negative correlation , short bowel syndrome , correlation , vitamin d and neurology , absorption (acoustics) , endocrinology , surgery , parenteral nutrition , physics , geometry , mathematics , acoustics
. Seventeen patients who had undergone extensive small bowel resection were studied for calcium absorption (FACa) and plasma vitamin D metabolites. FACa was measured by a double radiotracer technique and expressed as percentage of total oral dose. FACa was decreased compared with controls (34%, range: 3–46 v 65%, range: 57–73, P < 0·01). A positive correlation ( r = 0·49, P = 0·05) was found between FACa and the remaining length of small bowel (SBL). As wide variations in both SBL and duration after surgery were observed among the seventeen investigated patients, we were led to individualize less heterogeneous subgroups of patients. Better correlations were found when the patients were divided into two subgroups according to whether the time interval between the resection and the investigation was shorter ( r = 0·75, n = 11, P < 0·02) or longer ( r = 0·89, n = 6, P = 0·05) than 2 years. In thirteen patients who had a SBL shorter than 100 cm, a positive correlation was observed between FACa and the time interval after surgery (months): r = 0·65, P < 0·05. Plasma 1,25 (OH)2D was markedly reduced in the whole group (31 pmol l ‐1 , range: 8–108) compared with controls (103 pmol ‐1 , range: 59–134, P < 0·01). The present study shows that in extensively small bowel resected patients, calcium absorption is reduced, the alteration being dependent both on the length of the remnant small bowel and on the time after surgery. These results confirm that adaptive changes occur with time, but it is difficult to conclude whether a specific segment of the intestine is involved in the adaptative response.