MORPHOLOGY AND ABSORPTIVE CAPACITY OF ILEUM AFTER ILEOSTOMY IN MAN

A new ileostomy produces diarrhea which then gradually decreases in volume over the next three to four months. The role of the ileum in this apparent adaptation to loss of colonic water absorptive capacity was determined directly by measuring water absorptive capacity in ileal test segments in vivo. The results suggest that the initial diarrhea is caused at least in part by loss of normal absorptive capacity in the distal ileum and that the adaptation over the next several months actually is caused primarily by a return of ileal absorptive capacity to normal. The test segments also showed mucosal hyperplasia and hyperabsorption four months after ileostomy, suggesting that part of the adaptation may involve an increase in ileal absorptive capacity above normal. © 1969.