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Published on: September 27, 2017
Modulation by colonic fermentation of LES function in humans
T Piche1, F Zerbib, S B Varannes
1Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 539, Centre de Recherches en Nutrition Humaine, Centre Hospitalier Universitaire-Hôtel Dieu, 44035 Nantes Cedex, France.
Summary
Colonic fermentation of lactose and short-chain fatty acids (SCFAs) significantly impacts lower esophageal sphincter (LES) function, increasing transient relaxations and acid reflux episodes. This suggests a gut-brain-esophageal feedback mechanism.
Area of Science:
- Gastroenterology
- Human Physiology
- Digestive System Function
Background:
- Colonic carbohydrate fermentation influences gastrointestinal motility.
- The impact of colonic fermentation products on esophageal function requires further investigation.
Purpose of the Study:
- To investigate the effects of colonic lactose and short-chain fatty acid (SCFA) infusions on human lower esophageal sphincter (LES) function.
- To explore potential feedback mechanisms between the colon and the esophagus.
Main Methods:
- Healthy volunteers underwent monitoring of LES pressure, transient LES relaxations (TLESRs), and esophageal pH for 6 hours.
- Colonic infusions included saline, lactose, and SCFAs, tested under fasting and postprandial conditions.
- Plasma levels of Peptide YY (PYY) and oxyntomodulin (OLI) were measured.
Main Results:
- Both lactose and SCFA infusions increased the frequency and acid reflux association of TLESRs.
- SCFA infusion potentiated the postprandial decrease in LES pressure.
- Plasma PYY and OLI levels rose similarly across all infusion types.
Conclusions:
- Colonic fermentation of lactose significantly affects LES function, an effect mimicked by SCFA infusion.
- The findings suggest a feedback loop influencing esophageal function, potentially involving hormonal and/or neural pathways.
- Further research is needed to elucidate the precise mechanisms of this gut-esophageal interaction.
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