Abstracts
2002 Digestive Disease Week

# 104038 Abstract ID: 104038 Autotransplantation of the Small Bowel Does Not Alter Absorption of Water or Electrolytes from the Colon
Troy M Duininck, Karen D Libsch, Nicholas J Zyromski, Tatsuya Ueno, Judith A Duenes, Louis J Kost, Michael G Sarr, Rochester, MN

INTRODUCTION: Small bowel transplantation causes watery diarrhea. The decreases in absorption of water, electrolytes, and bile salts in jejunum and ileum, although present, are not dramatic (Surgery, 1994, 1995) and seem not to be great enough to explain the diarrhea. AIM: To determine changes in absorption of water and electrolytes in the colon after a canine model of jejunoileal autotransplantation under fasting and postprandial (PP) conditions. HYPOTHESIS: Colonic absorption of water and electrolytes decreases transiently in the colon after autotransplantation of small bowel. METHODS: 6 dogs had cannulas implanted into the in situ colon to study absorption in a 35-cm colonic segment via a triple-lumen perfusion technique. An isosmolar, ileal-like basal solution (in mEq/L; Na+ 130, K+ 10, Cl- 115, HCO3- 25) was infused at 5 ml/min. Absorption in the fasted and PP state was measured at baseline, and 2 and 12 wk after our previously well-validated model of jejunoileal autotransplantation (J Surg Res, 1989). RESULTS: All dogs developed profuse diarrhea after small bowel autotransplantation that resolved in 4-6 wk. After autotransplantation of jejunoileum net absorptive flux of water (µL/cm/min) in the colon did not change from baseline at 2 or 12 wk post-autotransplant (table). Fluxes of electrolytes (Na+, K+, Cl-) followed patterns similar to that of water (data not shown). Likewise, there was no difference in absorptive fluxes between the fasted and PP state at any time point. SUMMARY: Autotransplantation of the small intestine does not alter colonic absorption of water or electrolytes 2 or 12 wk after autotransplantation in the fasted or PP state. CONCLUSIONS: After autotransplantation of the small intestine although absorption of water, electrolytes, and bile salts in the small bowel are decreased, the colon maintains a baseline level of absorption of water and electrolytes at 2 and 12 wk. No PP augmentation of absorption 2 hr after a meal occurs in the colon at baseline or after this model of small bowel autotransplantation. These observations suggest that the neurally intact colon has a minimal role in the diarrhea after small bowel autotransplantation.