Ileal transposition into the upper jejunum affects lipid and bile salt absorption in rats

To determine whether ileal transposition affects absorption and transport of lipids and bile salts, we studied the absorption and lymphatic transport of triglyceride, cholesterol, and sodium taurocholate in rats with the distal quarter of their small bowel transposed to the proximal jejunum and in control rats whose intestines were transected and reanastomosed without transposition. Three weeks after transposition or sham surgery, rats were equipped with duodenal or jejunal and intestinal lymph duct cannulas and then given continuous duodenal or jejunal infusions of lipid emulsion containing triolein (40 mumol/h + [3H]triolein) and cholesterol (7.8 mumol/h + [14C]cholesterol) for 8 h. Lymph lipid output was measured; after 8 h of lipid infusion, luminal and mucosal radioactive lipid distribution was also quantified. Transposition had no effect on triglyceride absorption and transport, but cholesterol absorption and transport were both significantly attenuated in the transposed rats. In a separate study we examined whether ileal transposition would alter the kinetics of bile salt absorption. Six weeks after either transposition or sham surgery, rats were given a duodenal bolus injection of 14C-labeled sodium taurocholate mixed in rat bile, and the output of radiolabeled bile salt through a bile fistula was measured. Appearance of radiolabeled taurocholate was gradual in the control rats, peaking at approximately 90 min after administration. Appearance of labeled bile salt was rapid in the transposed rats, peaking within 60 min after administration. In conclusion, ileal transposition has no effect on triglyceride absorption but attenuates cholesterol absorption and transport, possibly by promoting premature absorption of bile salts.