Growth hormone, glutamine, and optimal diet fiber enteral nutrition for intestinal adaptation: Evaluation by morphology and magnifying colonoscopy

摘要

Introduction The administration of a combination of growth hormone, glutamine, and a modified diet improve absorption of nutrients for the patients with short gut syndrome was controversial. In this study, we evaluated the effect by morphology and zoom colonoscopy. Materials and methods A total of twelve patients with short bowel syndrome were studied. Active treatment was growth hormone, oral glutamine, and the optimal diet fiber enteral nutrition for at least 21 days. Two to four forceps biopsies are taken from the second part of duodenum pre- and post-treatment, pathology and immunopathologyof duodenal biopsies were obsreved, Three patients were observed by of magnifying colonoscopy. Results Compared to pre-treatment, the villus height and crypt depth of duodenum increased. Mucosal protein expression of caspas 3, Ki67,and p53 increased. Magnifying colonoscopy showed the enlagement of villi. Conclusions Treatment with growth hormone, glutamine, and optimal diet fiber enteral nutrition improved intestinal adaptation evaluated by morphology and magnifying colonoscopy. Recent evidence suggests the administration of a combination of growth hormone, glutamine, and a modified diet improve absorption of nutrients and reduce the long-term requirements for parenteral nutrition for the patients with short gut syndrome [1-3], however, the data from human trials is limited and conflicting [4-6].The purpose of this study was to examine whether growth hormone, rmone, glutamine, and optimal diet fiber enhance intestinal absorption evaluated by morphology and zoom colonoscopy