Resection of the Large Bowel Suppresses Hunger and Food Intake and Modulates Gastrointestinal Fermentation

Abstract

AttachedObjective: To a sse ss appetite and gut hormone levels in patients following partial (PR) or total resection (TR) of the large bowel. Methods: A com parative cro ss sectional study w as carried out with healthy controls (n = 99) and patients w ho had undergone P R (n = 64) or T R (n = 12) of the large bowel. Participants consum ed a standard (720 j kcal) breakfast meal at 0830 (f = 0) h followed by lactulose (15 g) and a buffet lunch (f = 210 min). Participants rated the subjective feelings of hunger at f = -3 0 , 0, 30, 60, 120, and 180 min. Breath hydrogen ; (BH) concentrations were also evaluated. In a m atched subset (11 controls, 11 P R and 9 T R patients) P Y Y and GLP-1 concentrations were m easured following breakfast. The primary outcom e m easure w as appetite, as m easured using visual analogue scale s and the buffet lunch. The secondary outcom e w as BH concentrations following a test meal. Results: P R and T R participants had lower hunger and energy intake at the buffet lunch meal com pared to controls. P R subjects had higher B H concentrations com pared to controls and T R subjects. B H levels correlated with circulating GLP-1 levels at specific time points. Conclusions: P R or T R of the large bowel reduced feelings of hunger and energy intake, and P R increased gastrointestinal fermentation.