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Digestive Health Summit – March 2005: Abstracts
The Impact of Digestive Health - Short and Long Term
Stephen J O'Keefe MD, MSc, FRCP
University of Pittsburgh Medical School
Food and digestive function are intimately interrelated. For example, digestion of proteins by proteolytic enzymes releases amino acids which are absorbed by cells that utilize the amino acids for the synthesis of digestive enzymes and absorptive processes. The high turnover rate of cells within the gut can only be maintained by a continuous supply of balanced nutrients, which includes amino acids for protein synthesis, carbohydrates and fatty acids for energy, vitamins, such as folic acid, B12, nicotinic acid, vitamin C and A, flavonoids and polyphenols for the regulation of cell differentiation and proliferation. Enteral nutrients are also critical for the synthesis of the gut-immune system, and sIgA deficiency can complicate starvation and lead to impaired gut mucosal defense and superimposed enteric infection, exacerbating malabsorption and diarrhea. Without a constant intake of food, motility and bacteriostatic secretions, such as gastric acid, pancreatic enzymes and bile acids, decrease leading to disturbances in colonic bacterial flora and overgrowth into the small intestine, further increasing infection risk, maldigestion and malabsorption. Consequently, chronic food deficiency will impair digestive function and result in a vicious cycle of maldigestion, malabsorption and diarrhea after refeeding, unless specific IV therapeutic interventions are employed. With regard to the colon, an inadequate supply of fiber and resistant starch will deprive the colonocytes of energy through impaired colonic bacterial production of short chain fatty acids, leading to deranged salt and water reabsorption and chronic diarrhea. In addition, the resulting butyrate deficiency will impair epithelial proliferation, differentiation and apoptosis, increasing the risk of neoplasia.
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