Role of the different parts of large bowel in influencing appetite

Abstract

OBJECTIVE: To determine the role of the different parts of the large bowel in influencing appetite DESIGN, SETTING AND METHODS: Seventy six colectomised subjects, age-sex matched with 76 healthy adults, were given a standard breakfast meal followed by a buffet lunch after 210 minutes. Hunger and satiety levels were determined at selected time points in patients and controls. Peptide YY (PYY) and glucagon likepolypeptide-1 (GLP-1) concentrations were determined in a sub sample of subjects. RESULTS: In proctocolectomised subjects at 180 minutes, a lower (p=0.035) hunger level and a higher (p=0.038) satiety level than controls were observed. The hunger ieveis of subjects with total removal of the rectum were lower at 60 min (p=0.048), 180 min (p=0.027), and 330 min (p=0.041) but higher at 240 min. The satiety levels were lower in subtotal/hemi-colectomised subjects at 300 (p=0.028) and 330 min (p=0.031). In subjects with remova! of the rectum, significantly lower hunger levels and higher satiety levels were observed at 180 minutes as compared to controls. In proctocolectomised patients, PYY concentrations were significantly lower than controls at 180 min (p=0.044). There was no difference in the GLP-1 concentrations between patients and controls. CONCLUSIONS: As subjects with removal of the rectum had significantly lower hunger levels and higher satiety levels at 180 minutes, a phenomenon not seen among subtotai/hemi-colectomised subjects, we surmise that the rectum has a significant role to play in controlling hunger and satiety levels. PYY is likely to be secreted from the large intestine and/or the rectum and GLP-1 from the small intestine.