Bacterial adaptation in patients with short bowel and colon in continuity

Abstract Background & Aims Long-term carbohydrate malabsorption in patients with short bowel and colon in continuity (SBC) could result in a more efficient fermentation. The bacterial fermentation capacity in patients with SBC was assessed. Methods Eleven fasting patients with SBC ingested 60 g lactulose with 10 g polyethylene glycol. Stool specimens were analyzed. Patients were compared with 8 normal subjects who ingested 60 g lactulose on two occasions, separated by 8 days during which 20 g lactulose was taken twice daily. Moreover, the daily amount of bacteria excreted in stools was measured in 6 patients with SBC and 6 normal subjects. Results Despite fast transit time, patients fermented more lactulose and hexoses and had a higher activity of β-galactosidase in stools than nonadapted normal subjects ( P P P