Effect of ingestion of fat on ileostomy effluent

Infusion of fat into the ileum slows small bowel transit and increases absorption of a carbohydrate meal. Paired studies were undertaken to investigate the effect of adding fat to the diet on gastrointestinal transit and absorption in eight people with terminal ileostomies. Each subject ate a daily diet that contained either low or high levels of fat but equivalent amounts of carbohydrate, protein, and fibre. Solid and liquid markers were added to the food to measure transit times. The ileostomy outputs after the meals were analysed for protein, fat, carbohydrate, polyethylene glycol, and the delivery of solid markers. All subjects produced more ileal effluent while taking the high fat diet compared with the low fat diet. Fat and protein outputs were significantly higher on the high fat days, but a greater proportion of the fat was absorbed during the high fat diet compared with the low fat diet. The output of carbohydrate on the two diets was not significantly different. The incorporation of fat in the diet produced no significant differences in the transit times of the first marker, but a slight prolongation of the transit time of the second marker. Increasing the fat content of the diet did not slow small bowel transit or increase nutrient absorption. The increase in protein and water output could be explained by an increased secretion of pancreatic enzymes.