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Am J Physiol Gastrointest Liver Physiol 278: G578-G584, 2000;
0193-1857/00 $5.00
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Vol. 278, Issue 4, G578-G584, April 2000

Modulation by colonic fermentation of LES function in humans

Thierry Piche1, Frank Zerbib1, Stanislas Bruley Des Varannes1, Christine Cherbut2, Younès Anini3, Claude Roze3, Alain le Quellec4, and Jean-Paul Galmiche1

1 Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 539, Centre de Recherches en Nutrition Humaine, Centre Hospitalier Universitaire-Hôtel Dieu, 44035 Nantes Cedex, France; 2 Institut National de la Recherche Agronomique, Nantes, France; 3 INSERM Unité 410, Faculté X Bichat, Paris, France; and 4 INSERM Unité 376, Montpellier, France.

Colonic fermentation of carbohydrate has been shown to influence gastric and intestinal motility. Our aim was to investigate the effects of colonic infusion of lactose and short-chain fatty acids (SCFAs) on lower esophageal sphincter (LES) function in humans. LES pressure (LESP), transient relaxations of LES (TLESRs), and esophageal pH were monitored over 6 h on 4 different days in 7 healthy volunteers. After 1 h of baseline recording, the effects of different colonic infusions (270 ml of isotonic or hypertonic saline, 30 g lactose, or 135 mmol SCFAs) were tested in fasting conditions and after a standard meal. Peptide YY (PYY) and oxyntomodulin (OLI) were also measured in plasma. Both lactose and SCFA infusions increased the number of TLESRs as well as the proportion of TLESRs associated with acid reflux episodes, but saline solutions did not. The postprandial fall of LESP was enhanced by previous SCFA infusion. Plasma PYY and OLI increased similarly after all colonic infusions. Colonic fermentation of lactose markedly affected LES function, and this effect was reproduced by SCFA infusion. Whether the mechanisms of this feedback phenomenon are of hormonal nature, neural nature, or both remains to be determined.

esophageal manometry; short-chain fatty acids; gastroesophageal reflux; peptide YY; oxyntomodulin





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