The effect of oral isocaloric feeding on small intestinal structure and function was studied in the rat. The liquid 'elemental' enteral feed Vivonex HN, the liquid 'complete' feed Ensure and the same liquid complete feed with 9% bulk Enrich were compared with solid chow containing 21% bulk (normal rat chow), all given for four weeks. Weight gain was significantly less in the group fed Vivonex HN than that of any other groups. The bulkless Vivonex HN and Ensure increased proximal jejunal mass compared to Enrich with 9% bulk or to normal rat chow. Jejunal mucosal DNA and protein levels also tended to be higher in Ensure and Vivonex HN fed animals, as was jejunal sugar absorption. In the terminal ileum, however, total weight was decreased by both elemental and complete feeds with and without bulk, but particularly by the elemental diet. Bulkless feeds therefore increase jejunal and reduce terminal ileal mass. The striking atrophy of the terminal ileum produced by the elemental diet may be important for its efficacy in treating inflammatory bowel disease.
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