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Effect of fiber and its fermentation on colonic adaptation after cecal resection in the rat.

BACKGROUND
The role of fiber in postresection adaptation is poorly understood. We examined the significance of short-chain fatty acids produced by intracolonic fiber fermentation during colonic adaptation.


METHODS
Rats underwent one of three surgeries: control laparotomy, cecal resection, or cecal resection with placement of perfusion catheter. Rats of each surgical group were randomly assigned to receive treatment regimens of standard fiber diet (with or without fermentation-suppressing antibiotics), fiber-free diet, or diet plus intracolonic perfusion of short-chain fatty acids. Adaptation parameters of mucosal weight, mucosal DNA and protein content, water absorption, and butyrate absorption were measured.


RESULTS
Compared with controls, postresection rats that were fed fiber had 65% greater basal and 112% greater butyrate-stimulated water absorption as well as 140% greater butyrate absorption. Fiber-fed rats exhibited significantly greater colonic weight and colonic mucosal protein after cecal resection. These changes were absent in postresection rats fed a fiber-free diet. Inhibition of fermentation by neomycin and metronidazole added to a standard fiber diet also prevented postresection adaptation. All adaptive changes were restored when the cecal-resection rats that were fed the fiber diet with antibiotics received an intracolonic infusion of short-chain fatty acids. Adaptation did not occur when short-chain fatty acids were infused into colons of postresection rats that were fed a fiber-free diet.


CONCLUSIONS
Cecal resection leads to significant functional and structural changes in the adapting residual colon. Fermentation of dietary fiber by colonic flora to short-chain fatty acids is necessary, but it alone is not sufficient to mediate adaptation.