Intestinal adaptation after jejuno-ileal bypass operation for massive obesity

Intestinal adaptation was studied in six patients with massive obesity treated by jejuno-ileal bypass operation. Glucose absorption in the jejunum was measured by a perfusion technique. The morphometric and enzymatic measurements were carried out on biopsies from the proximal jejunum and the distal ileum. Results obtained before and six months after the operation were compared. The glucose absorption per unit length of jejunum was unchanged at a glucose concentration of 66 mmol/l in the perfusate but increased significantly at a glucose concentration of 133 mmol/l (p less 0.025). The mean sucrase activity did not change, whereas the lactase activity increased significantly in the jejunum and ileum. The mean villus height increased significantly, while the epithelial cell height and cell width were unchanged both in the jejunum and the ileum, suggesting that the operation resulted in epithelial cell hyperplasia. The glucose absorption in the jejunum was positively correlated with the villus height (r = 0.76), which suggests that the increased glucose absorption was related to an increased number of epithelial cells.