Relationship of jejunostomy and urine polyamine content to refeeding and intestinal structure and function

The polyamine content of the intestinal mucosa is increased with mucosal proliferation. Our purpose was to determine if urine and jejunostomy polyamine content increases after refeeding and correlates with intestinal length and carbohydrate absorption after intestinal resection. Five patients with intestinal remnant lengths ranging from 1.5 to 8 feet after intestinal resection and jejunostomy formation were studied after refeeding of an elemental diet. Mean putrescine and spermidine levels in the jejunostomy effluent but not in the urine increased significantly after refeeding (p less than 0.05). These changes correlated with intestinal remnant length and carbohydrate absorption. Carbohydrate absorption correlated with polyamine levels in a single patient studied longitudinally. The polyamine content of intestinal fluid may serve as a marker of the status of the intestinal mucosa and may prove useful in the dietary management of individuals with the short bowel syndrome.