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Modification of small bowel mechanosensitivity by intestinal fat
A M Accarino1, F Azpiroz, J R Malagelada
1Digestive System Research Unit, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Barcelona, Spain.
Background:
Lipids may exacerbate symptoms induced by gut stimuli.
Aim:
To determine the mechanism whereby fat exerts this effect.
Subjects:
Twenty four healthy subjects were studied during fasting.
Methods:
We measured perception (0-6 scale) in response to jejunal balloon distension and transmucosal electrical nerve stimulation; phasic stimuli (one minute) were randomly applied at five minute intervals during intestinal infusion (2 ml/min) of saline and then Intralipid 2 kcal/min (high fat; n=8 subjects), Intralipid 0.5 kcal/min (low fat; n=8), or saline (n=8).
Results:
Intestinal lipids increased the perception of jejunal distension regardless of concentration (by 53% with high fat, 49% with low fat, and 17% with saline; p<0.05 for both fat loads). This effect could not be attributed to changes in intestinal compliance as intraballoon pressures remained unchanged during lipid infusion (2% change; NS). Sensitisation induced by lipids seemed to be specifically related to intestinal mechanoreceptors because electrical stimulation, which non-specifically activates gut afferents, was perceived equally during saline and lipid administration (10%, 11%, and 15% change during high fat, low fat, and saline, respectively; NS).
Conclusion:
Physiological amounts of lipids heighten intestinal sensitivity by modulating intestinal mechanoreceptor response.
