Insights into the different effects of food on intestinal secretion using magnetic resonance imaging

Wilkinson-Smith, Victoria C.; Major, Giles; Ashleigh, Lucy; Murray, Kathryn; Hoad, Caroline L.; Marciani, Luca; Gowland, Penny A.; Spiller, Robin C.

Abstract

Background: Plant foods may stimulate intestinal secretion through chemicals designed to deter herbivores, including lactucins in lettuce and rhein in rhubarb. This may increase ileostomy output and induce diarrhoea in people with intact bowels.
Objective: We aimed to determine the effect of food on intestinal water content using Magnetic Resonance Imaging (MRI).
Design: A three period crossover trial of isocaloric meals in adults without bowel disorders. Meals: 2 slices white bread with 10 g butter; 300 g rhubarb with 60 mL lactose free cream; 300 g lettuce with 30 mL mayonnaise. Primary outcome: Area under curve (AUC) small bowel water content (SBWC) using MRI. Secondary outcomes: ascending colon water content; T1 relaxation time of ascending colon (T1AC); gastric volume; visual analogue scales of bloating and satiety (0–100). MRI analysts were blinded. Scanned fasting and hourly to 180 min postprandial. Symptoms scored half‐hourly.
Results: 9 female and 6 male subjects completed the study. AUC SBWC fell after bread but rose after lettuce and even more after rhubarb, difference from baseline being (Bread AUC −5662 (1209) ml.min vs Lettuce 3194 (1574) ml.min and Rhubarb 10586 (1629) ml.min (P less than 0.01). Rhubarb induced a rise in T1AC but differences at 3 hours were not significant (P = 0.06). Gastric volume at T = 0 significantly was higher for both lettuce and rhubarb (571 ± 92 and 558 ± 89 mls) respectively compared to bread (314 ± 108 mls) (p less than0.0001). Symptom scores were higher for lettuce > rhubarb > bread.
Conclusion: Lettuce and rhubarb meals increased intestinal water content, demonstrating how different foods can alter ileal flow and stool consistency.

Citation

Wilkinson-Smith, V. C., Major, G., Ashleigh, L., Murray, K., Hoad, C. L., Marciani, L., …Spiller, R. C. (2018). Insights into the different effects of food on intestinal secretion using magnetic resonance imaging. Journal of Parenteral and Enteral Nutrition, 42(8), 1342-1348. https://doi.org/10.1002/jpen.1157

• Journal Article Type: Article
• Acceptance Date: Feb 8, 2018
• Online Publication Date: Mar 30, 2018
• Publication Date: Nov 1, 2018
• Deposit Date: Feb 23, 2018
• Publicly Available Date: Mar 31, 2019
• Journal: Journal of Parenteral and Enteral Nutrition
• Print ISSN: 0148-6071
• Electronic ISSN: 1941-2444
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Issue: 8
• Pages: 1342-1348
• DOI: https://doi.org/10.1002/jpen.1157
• Public URL: https://nottingham-repository.worktribe.com/output/922318
• Publisher URL: https://onlinelibrary.wiley.com/doi/full/10.1002/jpen.1157
• Additional Information: Additional authors: Nottingham GI MRI Research Group.; ; This is the peer reviewed version of the following article: Victoria C. Wilkinson-Smith, Giles Major, Lucy Ashleigh, Kathryn Murray, Caroline L. Hoad, Luca Marciani, Penny A. Gowland, Robin C. Spiller, Nottingham GI MRI Research Group, Insights into the different effects of food on intestinal secretion using magnetic resonance imaging, Journal of Parenteral & Eneral Nutrition, which has been published in final form at doi:10.1002/jpen.1157. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.