Ileocal valve

[JimWlf]

I lost 72cm of intestines, incl. my Ileocal valve due to a construction accident, suffer from  SBS and am being currently treated. What I wish to know is how the Ileocal valve functions: is it a 'pressure valve' in the sense that it opens when there is a constant build up to a certain level , or is it release small amounts on a more constant basis? It would seem that there might be a way to constrict the location where it should be from outside the intestines, similar to a lap band but flexible. Any improvement would be a godsend for many people suffering from SBS, now & in the future. If an organ as complex as the human heart can be created, with functional valves that finely tuned, it seems as if much simpler replacement for the Ileocal valve could be found. Even something as simple as non-rejectable surgical tubing to slow the progression of food through the intestinal tract would aid the body in absorbtion and the small & large intestines in recovery. It seems that no one has done this, and there may be other locations in the human body where something similar would be a great benefit. From an academic standpoint I know doctors understand how serious SBS is, but believe me, living with it is another matter! So first, how does the Ileocal valve work? Then how can its function be duplicated, the nutrients slowed through the small intestines & colon, and aiding them to recover, in particular the Villi? Any research being done, if not, why?
Thank you very much, I appreciate the ability to post this. Jim W

[CalGal]

Jim, if you read through the literature on the ileocecal valve, you'll find that they're not exactly sure how it fundtion. Yes, there does appear to be a pressure component, however there also appears to be a neural component, and it appears to work in coordination with the duodenaljejunal sphincter. So it's not quite a simple as pressure sensitive.

It's also 'position' sensitive. The angle between the ileum and cecum is maintained by the superior and inferior ileocecal ligaments. The competence of the ileocecal sphincter, and the contribution made by the external ligamentous attachments to competence at that junction have been tested.  

In investigations of human autopsy subjects within two hours of death, researchers retrogradely filled the ascending colon with a saline solution. In the subjects, the ileocecal sphincter maintained competency (i.e., lack of reflux) in the face of pressures up to 80 mmHg.

A continuation of the studies in the competent subjects revealed when the researchers removed either ileocecal junction mucosa, or a strip of circular muscle, neither technique was enough to impair competence to pressures above 40 mmHg. Disabling the superior and inferior ileocecal ligaments via division of the fibrous tissues maintaining the angle between the ileum and the cecum, however, rendered the junction incompetent in all subjects.  

Surgical reconstruction to restore the ileocecal junction angle in some of the subjects returned junctional competence.

Comparable observations were also made during in vivo studies in dogs. Results suggest similar mechanical factors, as represented by the external anatomy, contribute to competence at the ileocecal junction.  

So if you're thinking of reconstruction of a 'tissue' valve, it might be difficult to do. Perhaps a mechanical valve? But I think it's going to take a fair amount of work to get something seeminly so 'simple' to actually function.

[JimWlf]

Thank you, I had not run across that information!  In my case I no longer have an Ileocal valve (it's in a landfill somewhere), and there is so much garbage on the dumpster the web has become, it's Great to finally find a decent forum for information, but I would like to know your source for that information. A mechanical Valve is Just what I'm talking about. Anything that slows the food transmission from the small intestines to the colon! It sounds like they have a good idea of the pressures involved, now if we can only get a research medical college interested.... Interestingly in my case the intestines did not appear to be normally attached, yet I had no problems pre-accident; but then when a two ton block of cement lands on you, well, it Was a mess in there. Thank you Very much CalGal, Hope you remeber where the information came from. (this may be a repeat message-my internet connection got wied there). JimWlf