Effects of oral supplement of L-glutamine on diverted colon wall

Abstract

Diverted colorectal segments can present trophic and inflammatory changes. These alterations are of special importance in the patients whose colostomy becomes permanent, as well as in the differential diagnosis with other inflammatory diseases. This study was accomplished to quantify these alterations and to determine if oral supplement of L-glutamine would avoid them. Twenty-six adult male Wistar rats were distributed in three groups: control, colostomized and colostomized+L-glutamine. The colostomized group received a loop colostomy. The colostomized+L-glutamine group received a colostomy similar to the previous group and oral supplement of L-glutamine. Partial volumes of all layers of the colonic wall were measured by image analysis stereology. The diversion caused a decrease of partial volumes of the mucosa and the epithelium as well, and also of the height of the intestinal crypts (p<0.05). There was an increase of partial volumes of the lamina propria, of the submucosa and of the muscularis mucosae vs controls (p<0.05). The partial volume of the muscularis propria didn't show significant alteration. The supplementation of L-glutamine was effective in preventing the atrophy of mucosa and epithelium (p<0.05), also avoiding the increase of partial volumes of the submucosa and lamina propria (p<0.05). This supplement didn't change significantly the muscular layers. In conclusion, colostomy causes the atrophy of the colon wall, mainly due to the atrophy of the epithelium. The supplementation of L-glutamine is able to avoid these changes.