REVIEW: Small Bowel Review: Normal Physiology, Part 1

  title={REVIEW: Small Bowel Review: Normal Physiology, Part 1},
  author={Alan B. R. Thomson and Laurie A. Drozdowski and Claudiu Iordache and Ben K.A. Thomson and S{\'e}verine Vermeire and Michael Tom Clandinin and Gary Wild},
  journal={Digestive Diseases and Sciences},
In the past year there have been many advances in the area of small bowel physiology and pathology and therapy. In preparation for this review, over 1500 papers were assessed. The focus is on presenting clinically useful information for the practising gastroenterologist. Selected important clinical learning points include the following: (1) glucose absorption mediated by SGLT1 is controlled by mRNA abundance, as well as by posttranscriptional processes including protein trafficking; (2… 

Gene expression in the adapting small bowel after massive small bowel resection

DD-PCR analysis showed regulation of a number of genes not previously known to be involved in adaptation after MSBR or previously characterized in the intestine that may be important in bringing about the complement of changes seen during the adaptive response.

Patients with chronic kidney disease have abnormal upper gastro‐intestinal tract digestive function: A study of uremic enteropathy

This present study was designed to comprehensively describe upper GI function in those with advanced renal impairment.

Omega-3 fatty acids in immune-enhancing enteral diets selectively increase blood flow to the ileum by a bile acid dependent mechanism.

Omega-3 fatty acids are the components of the enteral IED, Impact, which produce the increased blood flow to the terminal ileum and its contiguous gut-associated lymphoid tissue, and this data suggests that an intact enterohepatic bile pathway is needed for the IED blood flow effect.

The human jejunum has an endogenous microbiota that differs from those in the oral cavity and colon

The jejunal lumen contains a distinctive bacterial population consisting primarily of facultative anaerobes and oxygen-tolerant obligates similar to those found in the oral cavity, however, the frequent abundance of Enterobacteriaceae represents a major difference from oral microbiota.

Carbohydrate supplementation: a critical review of recent innovations

Novel carbohydrate supplements including multiple transportable carbohydrate, modified carbohydrate, and hydrogels (HGEL) have been generally effective at modifying gastric emptying and/or intestinal absorption, but how this affects the ergogenicity of carbohydrate is still mostly unknown.

Iron metabolism in end stage renal failure: rationale for re-evaluation of parenteral iron therapy

Although parenteral iron achieves seemingly favourable short results, there are no data for its safety in the long term and there are reasons to suggest possible iron overload with chronic use.

Eusorbents and Eusorption: A Review of Physiological Events to Therapeutic Concepts

The eusorption paradigm in the optimization of oral rehydration and the treatment of diarrhea is reviewed to contribute to the understanding of absorptive enhancements of specific substances and their properties that facilitate the desired effects in health and disease.



In vivo measurement of intestinal absorption using 3-0 methylglucose in short bowel syndrome.

Results show that 3-0 MG is useful in measuring nutrient absorption capacity in rats after massive small bowel resection, and further studies to validate these methods in human patients with short bowel syndrome are suggested.

Glutamine ameliorates mechanical obstruction-induced intestinal injury.

It is shown that glutamine can significantly reduce the degree of those physiological derangements induced by mechanical intestinal obstruction and the obstruction-induced mucosal injury was substantially improved in glutamine-fed rats.

Cisplatin impairs fluid and electrolyte absorption in rat small intestine: a role for 5-hydroxytryptamine

The findings suggest that diarrhoea during cisplatin therapy may be due to altered fluid transport in the small bowel, and the reversal of fluid transport to normal in the presence of a 5-hydroxytryptamine3 receptor antagonist suggests that 5-Hydroxytiptamine is a local mediator in theSmall intestine.

Effect of intravenous ranitidine and omeprazole on intestinal absorption of water, sodium, and macronutrients in patients with intestinal resection

The effect varied significantly and was greater in patients with a high output, but did not allow parenteral nutrition to be discontinued, and absorption of energy, macronutrients, electrolytes, and divalent cations was not improved.

Effect of lactitol on blood ammonia response to oral glutamine challenge in cirrhotic patients: evidence for an effect of nonabsorbable disaccharides on small intestine ammonia generation

It is suggested that lactitol affects small intestine ammonia generation probably by shortening the residence time of intestinal contents by reducing the elevation in blood ammonia that follows oral glutamine challenge.

Intestinal bile acid transport: biology, physiology, and pathophysiology.

  • B. Shneider
  • Biology, Medicine
    Journal of pediatric gastroenterology and nutrition
  • 2001
Future studies of the transcriptional and posttranscriptional regulation of the ASBT gene and analysis of ASBT knockout mice will provide further insight into the biology, physiology, and pathophysiology of intestinal bile acid transport.

Modification of small bowel mechanosensitivity by intestinal fat

Physiological amounts of lipids heighten intestinal sensitivity by modulating intestinal mechanoreceptor response by exerting pressure on gut afferents through lipids.

Effect of sorbin on electrolyte transport in rat and human intestine.

The results indicate that C7-sorbin stimulated NaCl neutral absorption and inhibited electrogenic Cl- in rat and human intestinal epithelia and inhibited secretory agents such as secretin, vasoactive intestinal peptide, PGE2, and serotonin in rats and humans.

Contribution of villous atrophy to reduced intestinal maltase in infants with malnutrition.

The data directly demonstrate, for the first time, that the terminal steps of starch 1-4 starch digestion and sucrase-isomaltase 1-6 starch digestion are decreased in malnourished infants, secondary to villous atrophy.