Studies on infant diarrhea. II. Absorption of glucose and net fluxes of water and sodium chloride in a segment of the jejunum.

10 infants with acute diarrhea passing liquid stools were chosen for this study of electrolyte and glucose absorption and net water fluxes in a jejunal segment. Electrolyte and glucose solutions of varying concentrations were perfused through a 25-cm segment of proximal jejunum in normal infants and in those with diarrhea. Under equilibrium conditions net fluxes of water glucose and electrolytes were determined. Diarrhea patients had impaired glucose absorption (159 mcmol per minute) vs. control infants (351 mcmol per minute). The net flux of water and salt was dependent on the proportion of glucose absorbed. Thus when the amount of nonabsorbed glucose was high water and salt moved into the bowel. However in the absence of glucose there was minimal net absorption of water and sodium chloride in both patients and controls. The net flux of water and sodium chloride into the jejunum seems to be determined by the effective osmotic pressure exerted by unabsorbed solute. These studies demonstrate that the absorption of glucose by the jejunum is impaired in acute diarrhea of infancy; these studies also show that the associated net movement of fluid into the bowel in diarrhea occurs as a consequence of bulk flow determined by excesses of glucose in the bowel lumen.

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