Schwer verdauliche Saccharide

Zusammenfassung

Schwer verdauliche Saccharide sind enzymresistente Zucker bzw. deren Oligo- oder Polymere, die im Magen-Darm-Trakt des Menschen spezifische Wirkungen entfalten. Im Dünndarm beeinflussen sie die Digestion und Resorption von Energieträgern mit Rückwirkungen auf den Glukose- und Fettstoffwechsel. Hierdurch vermindern sie die bekannten Risikofaktoren von Gefäßkrankheiten. Im proximalen Kolon werden die Saccharide von den anaeroben Bakterien der Mikroflora abgebaut. Die Fermentation von Kohlenhydraten ist für das innere Milieu des Dickdarms von Bedeutung. Durch Stimulation des bakteriellen Teilungsstoffwechsels wird Stickstoff in der Bakterienfraktion fixiert und so zur Ausscheidung über den Stuhl gebracht; dieser Effekt kann bei Patienten mit Leberzirrhose zur Prävention oder Therapie der hepatischen Enzephalopathie genutzt werden. Butyrat, ein Endprodukt der bakteriellen Kohlenhydratfermentation, hat antiinflammatorische Eigenschaften und kann möglicherweise in der Therapie bestimmter Kolitisformen (Colitis ulcerosa, Pouchitis, Strahlenproktitis) eingesetzt werden. Diese kurzkettige Fettsäure regelt auch die Expression zahlreicher Gene, die mit der Karzinogenese im Zusammenhang stehen; insofern könnte sie in der Primärprävention des kolorektalen Karzinoms eine Rolle spielen. Nicht fermentierte Kohlenhydrate steigern die Stuhlmasse, wodurch die funktionelle chronische Obstipation und die symptomatische Divertikulose gelindert werden können. Hingegen ist ihre Rolle beim Reizdarmsyndrom noch nicht endgültig geklärt. Zusammenfassend gibt es Belege für die Annahme, dass schwer verdauliche Saccharide für zahlreiche Teilaspekte des physiologischen Verdauungsprozesses von großer Bedeutung sind.

Abstract

Low-digestible saccharides represent a class of enzyme-resistant sugars (or their oligomers/polymers) which have specific effects on the human gastrointestinal tract. In the small bowel, they affect nutrient digestion and absorption, glucose and lipid metabolism and, thus, reduce known risk factors of cardiovascular disease. In the proximal colon they are fermented by the anaerobic bacteria of the indigenous microflora. The fermentation of carbohydrates has a major impact on the luminal environment of the large gut. By stimulating bacterial proliferation, nitrogen is fixed in bacterial matter and, thus, nitrogen excretion is enhanced; this effect can be used to prevent or treat hepatic encephalopathy in patients with liver cirrhosis. Butyrate, an end product of bacterial carbohydrate fermentation, exhibits anti-inflammatory properties and may be used to treat distinct forms of colitis (ulcerative colitis, pouchitis, radiation proctitis). This short chain fatty acid also regulates the expression of numerous genes involved in the promotion of carcinogenesis and may have a role in the prevention of colorectal cancer. Unfermented carbohydrates increase faecal bulk which is important in the treatment of functional chronic constipation and symptomatic diverticulosis; however, their role in the management of the irritable bowel syndrome is not quite clear. In conclusion, there is evidence that low-digestible saccharides play a role in the maintenance of human digestive health.

Schlüsselwörter

Mikroflora - Fermentation - n-Butyrat - Kolitis - Karzinogenese

Key words

Microflora - fermentation - n-butyrate - colitis - carcinogenesis

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