Intestinal fuels: glutamine, short-chain fatty acids, and dietary fiber. 1992

M A Evans, and E P Shronts
Department of Pediatrics, University of Minnesota, Minneapolis 55455.

In recent years, considerable research has focused on the physiologic effects and clinical uses of three dietary constituents thought to be trophic to the intestinal tract in human beings: glutamine, short-chain fatty acids (SCFAs), and dietary fiber. Glutamine is an important nitrogen-carrying amino acid that may be "conditionally essential" in certain disease states to support the gut barrier and immune function and overall protein use. Colonic irrigations with SCFA preparations have demonstrated enhanced healing of bowel tissue in animals and human beings. Dietary fiber supports bacterial SCFA production, normal stool output, and the gut barrier and immune function. However, optimal fiber doses for various medical conditions are not known, and the risk for gastrointestinal (GI) obstruction, diarrhea, gas, and bloating necessitates careful selection of patients and daily monitoring of fiber tolerance. A review of the current literature indicates that widespread use of glutamine and SCFA additives parenterally and enterally awaits further evidence of safety and efficacy in human beings, establishment of appropriate doses, and advances in formulation technology. Administration of dietary fiber to enhance bowel motility should be considered in long-term tube-fed patients with intact GI function and sufficient fluid tolerance to permit hydration of fiber. Industrywide agreement on fiber analysis methods and labeling standards (eg, fiber fermentability vs solubility) would facilitate selection of enteral products. To streamline studies and optimize research efforts in future clinical trials, standard criteria for evaluating GI function, diarrheagenic factors, and intestinal outcome variables should be established.

UI MeSH Term Description Entries
D007422 Intestines The section of the alimentary canal from the STOMACH to the ANAL CANAL. It includes the LARGE INTESTINE and SMALL INTESTINE. Intestine
D010368 Pectins High molecular weight polysaccharides present in the cell walls of all plants. Pectins cement cell walls together. They are used as emulsifiers and stabilizers in the food industry. They have been tried for a variety of therapeutic uses including as antidiarrheals, where they are now generally considered ineffective, and in the treatment of hypercholesterolemia. Calcium Pectinate,Methoxy Pectin,Methoxylpectin,Methoxypectin,Pectin,Pectinic Acid,Zinc Pectinate,Pectin, Methoxy,Pectinate, Calcium,Pectinate, Zinc
D011134 Polysaccharides Long chain polymeric CARBOHYDRATES composed of MONOSACCHARIDES linked by glycosidic bonds. Glycan,Glycans,Polysaccharide
D004043 Dietary Fiber The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. Fiber, Dietary,Roughage,Wheat Bran,Bran, Wheat,Brans, Wheat,Dietary Fibers,Fibers, Dietary,Roughages,Wheat Brans
D004734 Energy Metabolism The chemical reactions involved in the production and utilization of various forms of energy in cells. Bioenergetics,Energy Expenditure,Bioenergetic,Energy Expenditures,Energy Metabolisms,Expenditure, Energy,Expenditures, Energy,Metabolism, Energy,Metabolisms, Energy
D004750 Enteral Nutrition Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. Enteral Feeding,Force Feeding,Nutrition, Enteral,Tube Feeding,Gastric Feeding Tubes,Feeding Tube, Gastric,Feeding Tubes, Gastric,Feeding, Enteral,Feeding, Force,Feeding, Tube,Feedings, Force,Force Feedings,Gastric Feeding Tube,Tube, Gastric Feeding,Tubes, Gastric Feeding
D005232 Fatty Acids, Volatile Short-chain fatty acids of up to six carbon atoms in length. They are the major end products of microbial fermentation in the ruminant digestive tract and have also been implicated in the causation of neurological diseases in humans. Fatty Acids, Short-Chain,Short-Chain Fatty Acid,Volatile Fatty Acid,Acid, Short-Chain Fatty,Acid, Volatile Fatty,Fatty Acid, Short-Chain,Fatty Acid, Volatile,Fatty Acids, Short Chain,Short Chain Fatty Acid,Short-Chain Fatty Acids,Volatile Fatty Acids
D005526 Food, Formulated Food and dietary formulations including elemental (chemically defined formula) diets, synthetic and semisynthetic diets, space diets, weight-reduction formulas, tube-feeding diets, complete liquid diets, and supplemental liquid and solid diets. Diet, Chemically Defined,Diet, Elemental,Diet, Formula,Diet, Synthetic,Dietary Formulations,Chemically Defined Diet,Synthetic Diet,Chemically Defined Diets,Dietary Formulation,Diets, Chemically Defined,Diets, Elemental,Diets, Formula,Diets, Synthetic,Elemental Diet,Elemental Diets,Foods, Formulated,Formulated Food,Formulated Foods,Formulation, Dietary,Formulations, Dietary
D005973 Glutamine A non-essential amino acid present abundantly throughout the body and is involved in many metabolic processes. It is synthesized from GLUTAMIC ACID and AMMONIA. It is the principal carrier of NITROGEN in the body and is an important energy source for many cells. D-Glutamine,L-Glutamine,D Glutamine,L Glutamine
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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