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Biomedical subjects

E W Pomare

Publications and source records attributed to E W Pomare.

At least 19 recordsLinked to original sources
PubMed1992

Portal and peripheral blood short chain fatty acid concentrations after caecal lactulose instillation at surgery.

The major end products of fermentation, short chain fatty acids (acetate, propionate, butyrate) were measured in portal and peripheral venous blood after the caecal instillation of lactulose at surgery in patients undergoing elective cholecystectomy. Blood samples for short chain fatty acid measurement were taken before and at 15 minute intervals up to 60 minutes after caecal instillation of either 20 ml sterile saline or 6.7 g or 10 g lactulose. Fasting concentrations (n = 28) were (mumol/l, mean (SD)); portal acetate 128.0 (70.8), propionate 34.4 (23.3), butyrate 17.6 (18.4); peripheral acetate 67.0 (23.0), propionate 3.7 (1.2), butyrate traces only. After lactulose there was a rapid rise in portal short chain fatty acids with peak concentrations being reached in 15 to 45 minutes. Mean peak concentrations (mumol/l (SD)) after 10 g lactulose were acetate 240.9 (142.2), propionate 39.0 (17.8) and butyrate 26.9 (17.6). The changes in acetate concentrations seen in portal blood were reflected in peripheral blood acetate measurements. In contrast with portal blood, only small amounts of propionate and traces of butyrate were found in peripheral blood.

Adult↗
PubMed1991

The contribution of the large intestine to blood acetate in man.

1. To test the hypothesis that the colon contributes significantly to venous plasma acetate concentrations, experiments were carried out in healthy volunteers and ileostomy patients. 2. Fasting plasma acetate levels were measured in 10 ileostomy patients and compared with those in 21 control subjects. Values in ileostomy patients (21.3 +/- 0.8 mumol/l) were significantly lower than in control subjects (48.0 +/- 4.2 mumol/l). 3. Plasma acetate concentration was estimated in eight healthy volunteers during 108 h of continuous fasting. Acetate concentrations rose significantly from 12 h (43.9 +/- 4.4 mumol/l) to 108 h of starvation (114.0 +/- 15.6 mumol/l) and fell back to normal fasting values on refeeding and another 12 h fast (44.3 +/- 4.7 mumol/l). 4. When colonic fermentation was stimulated after oral ingestion of 10 g of lactulose, the plasma acetate concentration increased significantly (from 44.0 +/- 7.4 to 114.4 +/- 16.2 mumol/l) in seven healthy control subjects. This rise was not affected by concomitant dosage of metronidazole. 5. These data suggest that there are at least two major sources of acetate in man, an endogenous source and the colon which probably becomes more important when fermentation of carbohydrate is occurring.

Acetates↗
PubMed1990

Functional gastrointestinal symptoms in a Wellington community sample.

In this study, gut functioning and the prevalence of functional bowel disorders among a Wellington community sample of 285 apparently healthy people was estimated using a standardised questionnaire. When asked for their opinion of their bowel functioning generally, 37% of respondents were satisfied that it was always normal, 57.2% regarded it as not always normal, and 5.6% felt it was normal less than half the time or not normal at all. However, only 11.6% had actually consulted a physician about a stomach or bowel disorder in the past year. Average bowel frequency was 8.4 movements per week (SD = 3.9) for the total sample. Approximately three quarters of the total sample had experienced diarrhoea at least occasionally, but only 2.5% half the movements or more often. Constipation was reported by 8.1% for half the time or more, and 1.8% for most bowel movements. Abdominal distension was experienced by 7.2% on half of days or more, and 3.6% on most days or daily. Abdominal pain occuring on six or more separate days in the previous year was reported by 26.4% of men and 31.9% of women. Pain not due to organic disorders that was colonic in nature and of the irritable bowel syndrome type was reported by 15.9% of men and 17.2% of women.

Abdominal Pain↗
PubMed1988

Groups with special health care needs.

Inadequate access to health services is a major problem for disadvantaged groups and the reasons for this presents health researchers with a special challenge. These groups include women, Maori people, the economically deprived, the handicapped and the geographically isolated. Maori groups are now advocating community and Marae-based health clinics whilst well women clinics have evolved from the women's health lobby. These initiatives have allowed the respective groups to take responsibility for their own health and be involved in the health decision-making process. With respect to the chronically disabled there is a continuing need for realistic support and careful evaluation.

Aged↗
PubMed1987

Short chain fatty acids in human large intestine, portal, hepatic and venous blood.

Evidence for the occurrence of microbial breakdown of carbohydrate in the human colon has been sought by measuring short chain fatty acid (SCFA) concentrations in the contents of all regions of the large intestine and in portal, hepatic and peripheral venous blood obtained at autopsy of sudden death victims within four hours of death. Total SCFA concentration (mmol/kg) was low in the terminal ileum at 13 +/- 6 but high in all regions of the colon ranging from 131 +/- 9 in the caecum to 80 +/- 11 in the descending colon. The presence of branched chain fatty acids was also noted. A significant trend from high to low concentrations was found on passing distally from caecum to descending colon. pH also changed with region from 5.6 +/- 0.2 in the caecum to 6.6 +/- 0.1 in the descending colon. pH and SCFA concentrations were inversely related. Total SCFA (mumol/l) in blood was, portal 375 +/- 70, hepatic 148 +/- 42 and peripheral 79 +/- 22. In all samples acetate was the principal anion but molar ratios of the three principal SCFA changed on going from colonic contents to portal blood to hepatic vein indicating greater uptake of butyrate by the colonic epithelium and propionate by the liver. These data indicate that substantial carbohydrate, and possibly protein, fermentation is occurring in the human large intestine, principally in the caecum and ascending colon and that the large bowel may have a greater role to play in digestion than has previously been ascribed to it.

Acetates↗
PubMed1987

In vivo studies with fibre components.

There are few studies in man examining the in vivo effects of dietary fibre on bile acid metabolism but divergent results have been recorded depending on the amount and type of fibre eaten. Studies in which the fibre components pectin, cellulose, and lignin were fed to normal volunteers for four weeks have been reported. The highly fermentable component pectin is associated with increased secondary bile acid formation in contrast to the partially fermentable component cellulose in which the opposite occurs. Lignin has no effect on bile acid metabolism. No component significantly alters biliary lipids. Since ordinary diets contain a mixture of different fibres the net effect will depend on the relative amounts of each. Significant changes in bile acid metabolism and biliary lipids in the longer term (greater than 4 weeks) however, are not precluded by the results of these short term studies.

Bile Acids and Salts↗
PubMed1986

Effects of the fibre components pectin, cellulose, and lignin on bile salt metabolism and biliary lipid composition in man.

Randomised crossover studies in three separate groups of 10 healthy volunteers were undertaken to determine the effects of biliary lipid composition and bile salt metabolism of daily dietary supplementation for four weeks with the purified fibre components pectin (12 g/day), cellulose (15 g/day) and lignin (12 g/day). The subjects' biles were initially unsaturated with cholesterol and no significant changes in the lithogenic indices or mean percentages of cholesterol, phospholipid, or total bile acids after any of the supplements were observed. After pectin, the mean (+/- SD) percentage of cholic acid decreased significantly from 42.8 (+/- 10.8) to 39.0 (+/- 11.2), the mean (+/- SD) percentage of deoxycholic acid increased significantly from 18.2 (+/- 13.7) to 25.4 (+/- 13.5) and C14-deoxycholate metabolites were raised significantly by 65%. After cellulose, the mean (+/- SD) percentage of chenodeoxycholic acid was increased significantly from 33.6 (+/- 6.3) to 35.4 (+/- 7.0), the mean (+/- SD) percentage of deoxycholic acid decreased significantly from 18.6 (+/- 9.6) to 14.2 (+/- 8.3) and C14-deoxycholate metabolites halved. Lignin did not exert any significant effects. Though these results show that individual fibre components are associated with quite different effects on bile acid metabolism, in the short term no significant effect on biliary cholesterol saturation was observed in bile initially unsaturated with cholesterol. The bile acid changes most likely result from the different effects on colonic metabolism induced by the individual fibre components.

Adult↗
PubMed1985

Psychoneurotic symptomatology in the irritable bowel syndrome: a study of reporters and non-reporters.

An appreciable proportion of the general population have the irritable bowel syndrome but do not report it. Results of psychological assessments showed that outpatients with the syndrome and non-reporters of it were psychologically similar, but both groups showed more somatic distress than normal controls. Anxiety, depression, obsessive compulsion, and interpersonal sensitivity were similar in both groups with the syndrome and the normal controls. The preponderance of women referred to outpatient clinics may reflect sociological factors rather than the severity of the irritable bowel syndrome.

Adolescent↗
PubMed1985

The effects of the fiber components pectin, cellulose and lignin on serum cholesterol levels.

Eight-week randomized cross-over studies in three separate groups of 10 healthy volunteers were undertaken to determine the effects of daily dietary supplementation with pectin (12 g/day), cellulose (15 g/day) and lignin (12 g/day) on serum lipid levels. Detailed dietary records were kept throughout the study and there was no significant change in dietary intakes except for the fiber supplement. Neither pectin, cellulose, nor lignin significantly altered serum total cholesterol, triglycerides, high-density lipoprotein cholesterol, or the ratio of high-density lipoprotein to total cholesterol in healthy normolipidemic subjects over four weeks.

Adult↗
PubMed1985

Carbohydrate fermentation in the human colon and its relation to acetate concentrations in venous blood.

There is now substantial evidence that some dietary polysaccharides, notably dietary fiber, escape absorption in the small bowel and are then broken down in the large intestine of man. The main end products of this colonic digestive process, which is anerobic, are short chain fatty acids (SCFA), and acetic, propionic, and butyric acids. Although these acids are known to be absorbed from the colon, their subsequent fate and significance is unknown. We have measured venous blood SCFA levels in healthy subjects after a 16-h fast, and then following oral doses of either 50 mmol SCFA, 5, 10, or 20 g doses of the fermentable carbohydrate lactulose, or 20 g of pectin. Fasting venous blood acetate was 53.8 +/- 4.4 mumol/liter (SEM) (n = 14). Fasting arterial blood acetate, taken simultaneously with venous blood in six subjects, was higher; 125.6 +/- 13.5 mumol/liter (arterial) vs. 61.1 +/- 6.9 mumol/liter (venous). Significant levels of propionate or butyrate were not detected in any blood samples. Following an oral dose of 50 mmol mixed SCFA, venous blood acetate reached a peak of 194.1 +/- 57.9 mumol/liter at 45 min and returned to fasting levels at 2 h. Blood acetate also rose in response to lactulose, peak levels occurring 2-4 h after the dose: 5 g, 98.6 +/- 23.1 mumol/liter; 10 g, 127.3 +/- 18.2 mumol/liter; and 20 g, 181.3 +/- 23.9 mumol/liter. Pectin fermentation was much slower, with blood acetate levels starting to rise after 6 h and remaining elevated at about twice fasting levels for the subsequent 18 h. However, areas under the blood acetate curves were closely related (r = 0.97; n = 5), whatever the source of acetate. These studies show that the large intestine makes an important contribution to blood acetate levels in man and that fermentation may influence metabolic processes well beyond the wall of this organ.

Acetates↗
PubMed1984

Specificity of psychological profiles of irritable bowel syndrome patients.

The aim of the study was to investigate the specificity of psychological profiles in female Irritable Bowel Syndrome (IBS) patients by a comparison with a gastrointestinal patient control group and with a normal population control group. The results showed that the IBS patients scored significantly higher than the normal population sample on three test scales: Anxiety, Phobic and Somatisation. Our results thus support the conclusion of earlier authors that a moderate degree of psychoneurotic disorder exists amongst IBS patients. However, the patient control group also scored significantly higher than the normal control group on two factors (Phobic and Somatisation), and the comparison between the IBS group and the patient control group did not reveal any significant differences. It is suggested that attention to the psychological needs of both IBS and other gastrointestinal disease patients should form an important part of the management strategy, particularly in the former--where a consistently clear benefit for any particular therapy has yet to be shown.

Anxiety↗
PubMed1984

Irritable bowel patients and their long-term response to a high fiber diet.

Clinical details of 30 Caucasian women suffering from the irritable bowel syndrome were analyzed. Dietary fiber intakes, stool transit time, and stool weights were compared between groups of differing bowel habit and no statistically significant differences were found. A significant correlation between the clinical severity and the anxiety score on the Middlesex Hospital Questionnaire was present, but there was no correlation with other psychoneurotic traits or self-rating depression scores. Two to 3-year follow-up after management with a high fiber diet in 14 patients, showed that symptoms had improved greatly in seven, were unchanged in five, and were worse in two. Although dietary fiber had increased by a mean of 6.7 g/day, the clinical course could not be correlated with the amount of fiber consumed nor was it possible to predict the course of the individual patient from any clinical or psychological score. Despite persistence of symptoms at follow-up these were generally less severe and associated with significant decreases in anxiety, somatic and self-rating depression scores with the somatic score correlating with a decrease in clinical severity.

Adolescent↗
PubMed1983

Differing effects of pectin, cellulose and lignin on stool pH, transit time and weight.

Randomized cross-over studies were undertaken to determine the effects of daily dietary supplements of pectin (12 g/d), cellulose (15 g/d) and lignin (12 g/d) on stool characteristics of healthy volunteers. Detailed dietary records were kept throughout the study. Stool collections over 48 h were used to determine mean stool pH and weight. The single stool transit time was measured using radio-opaque markers. Pectin did not significantly alter the mean stool pH, transit time or 24 h wet weight. Cellulose lowered the mean stool pH from 6.38 to 6.12, decreased mean stool transit time by 27% and increased mean wet stool weight by 57%. Lignin lowered the mean pH from 6.34 to 6.25, decreased the stool transit time by 20% and increased stool weight by 27% but these changes were not statistically significant. These findings have shown that individual fibre components have different colonic metabolic effects and support the view that associations between dietary fibre intakes and diseases such as colorectal cancer should be evaluated with regard to the type of fibre components consumed.

Adult↗
PubMed1982

Dietary intakes and stool characteristics of patients with the irritable bowel syndrome.

Detailed dietary records were obtained from 30 women with the irritable bowel syndrome and 25 healthy, asymptomatic women. Stool transit times and wet stool weights were measured. Analysis of the dietary data revealed no significant difference between energy, protein, fat, carbohydrate, or total fiber intakes. Total dietary fiber intake was 17 g/day in the irritable bowel group and 18 g/day in the control group, but vegetable fiber intake was significantly lower in the patients (6.6 g/day) than the controls (8.2 g/day). Cereal and fruit fiber were comparable for both groups as were the stool transit times and wet stool weights. These results do not support the hypothesis that symptoms of the irritable bowel syndrome are directly related to total or cereal fiber depletion.

Adolescent↗
PubMed1981

Acute oesophagitis due to emepronium bromide.

Six cases of endoscopically documented acute oesophagitis during therapy with emepronium bromide (Cetiprin) for urinary symptoms are described. The oesophagitis was associated with acute severe retrosternal pain and dysphagia which resolved spontaneously on stopping medication. The potential of this drug to induce severe oesophageal inflammation and ulceration should be emphasised.

Acute Disease↗