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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.

American Journal of Physiology. Gastrointestinal and Liver Physiology
|April 14, 2000
PubMed
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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.

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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.