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With mother's milk, in the colon a buffer system round pH 5 is dominating which consists of short chain organic acids and the corresponding anions. Thus, the activity of the microbial metabolism is retarded. The degradation of lactose remains maintained down to the faeces. With cow's milk, a neutral buffer system on the basis of phosphate, bicarbonate, and protein degradation products causes a rapid lactose degradation already in the upper colon. Putrefactive metabolites thereby released and absorbed burden the infant's still immature detoxifying capacity.

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In connection with the electron-microscopy of bioptic material from the upper small intestine of children with intestinal diseases and diarrhea (10 months to 8 years) we found some cases of fungus infection (26%) besides many cases of bacterial attachment to the intestinal epithelium (72%). On the intestinal wall normal yeasts, pseudomycelium and common mycelium are visible. Partly the epithelium was entirely covered with mycelium. In some cases the hyphae invaded in the intestinal wall. The epithelium and the villi are not or only slightly altered. This gives the reason to believe that the fungi participate in inducing diarrhea. After medicamentous treatment with nystatine-preparations in some cases the health state of these children was improved.

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Manasan is an adapted formula for infants on the basis of cow's milk simulating the mode of action of human milk on faeces-pH and faeces microflora. In two temporally separated tests the effect of Manasan-feeding on faeces-pH, faeces flora, and acid-base-homeostasis was controlled and compared with the effect of human milk and Ki-Na-formula. With Manasan fed up from birth or following breast-feeding faeces-pH was to be found in an acid range, clearly. With Ki-Na the faeces-pH was situated in the neutral range. With Manasan the bacteria flora revealed a noteworthy decrease in the number of Bacteroides germs achieving a non-putrefactive milieu. Concerning the acid-base-homeostasis as with human milk so with Manasan late metabolic acidosis were to meet rarely. The experiments revealed that in important parameters, particularly with microecological signs, Manasan is comparable with human milk.

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Laboratory rats with a gut flora unambiguous free from Bifidobacterium revealed three days after an application of a lactose-rich food a dominating Lactobacillus plantarum flora. Up from this date, Bifidobacterium could be detected for the first time. At the beginning, there was to be observed merely B. adolescentis and B. pseudolongum, at the 5th to the 10th day B. bifidum supervened. Finally this species together with B. infantis was dominating. With in vitro experiments, by a systematic modifying of the medium changes from Bifidobacterium species typical to faeces from infants to such species only to meet in faeces from adults could be observed only after a long time of cultivation.

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6 typical bacteria species of the human intestinal flora (E. coli, Klebsiella pneumoniae, Proteus vulgaris, Streptococcus faecalis, Bacteroides fragilis, Bifidobacterium sp.) were incubated in a liquid medium for 48 h with [15N2]-urea and [15N]-ammonium chloride. The rates of [15N]-incorporation were calculated. They depend reproducible on the species examined, on the kind of the offered NPN-substance and on the amount of NPN-substance in the medium. With [15N2]-urea the minimal rate of incorporation was 3.8% (E coli) and the maximal one 95.6% (Bifidobacterium sp.). With [15N]-ammonium chloride the corresponding figures were 31.0 (Proteus vulg.) and 98.0% (Bifidobacterium sp.). The findings are discussed with regard to a possible enteral detoxification in uremic patients by bacterial utilization and elimination of urea and ammonia.

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Germ-free rats were monoassociated by E. coli germs not utilizing (L-) or utilizing lactose (L+) on endo-medium. There was no influence of germ status on the beta-galactosidase activity in the mucosa of the small and large intestine. With standard food, beta-galactosidase activity were to be measured in the chymus of all intestinal segments and in the faeces of germ-free as well as of monoassociated rats. In the chymus of caecum and colon and in the faeces of E. coli(L+)-animals, only, the short-time (12-16 days) application of lactose containing food resulted in an increase of the enzyme activity. Compared with the E. coli(L-)-animals, the lactose content in the chymus of all intestinal segments of this test group was decreased.

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The repercussion of nutrition on the food behaviour, bowel function and body mass development of rats with ileostomata and colostomata has been studied during the perioperative phase. An and libitum feeding until immediately before the operation has been found to be beneficial. The postoperative dietetic regimen is of decisive importance to the survival of the animals operated on. The best postoperative development was achieved in ileostomized rats by a diet rich in nutrients and energy, and low n bulkage. In rats with colostomata, the success of the operation may be impaired by a constipation in the intestinal region before the stoma, which frequently leads to occlusion. A spontaneous evacuation of chyme was induced in these animals only by a high-lactose and low-protein diet. It is recommended to keep the experimental animals on pre- and postoperative diets which take into account the location of the respective enterostoma.

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Female lactose adapted rats were kept for 10 days on human milk (HM), a milk diet adapted to human milk (MD1), and a milk diet rich in protein and phosphate (MD2), the lactose supply being always the same. In the caecum, colon and faeces, the pH value, the phosphorus content, the buffer capacity and the numbers of microorganisms with proteolytic activity (Bacteroides, Klebsiella, Proteus) were lower and the lactose concentration and the beta-galactosidase activity were higher on HM and MD1 than on MD2.

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Under certain circumstances--invasion of adhesive germs, abundant reproduction of the germs at the mucosa, a lowered resistance of the body--the adhesive flora can become a pathogenic factor itself. All hitherto known researchers point out that, in this connection, adhesions at the small intestinal wall is of main importance, as could be shown by our experiment with gnotobiotic rats, too. From the results of our experiments regarding the adhesion mechanisms, we conclude that the possibilities of prophylaxis and therapy of gastrointestinal disturbances induced by microbial effects could be extended by means of aimed inhibition of such adhesion forces.

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Man is habitat of 10(14)-10(15) bacteria, most of them colonizing the digestive tract, mainly the large intestine. Here microbial metabolic processes are going on like in a black box. Their quality, quantity, dynamics and effects on the host are discernible only in fragments or from their net effect. Almost all organic compounds and nutrients, fiber, xenobiotics, digestive secretions and desquamated epithelial cells of the host enter into macroorganismic/microorganismic metabolic chains and processes, which are not known or measurable in detail. Examples are given for the metabolization of nutrients, esp. amino acids. Some information is concerned with morphological, physiological, biochemical immunological and pathological effects of the gastrointestinal flora, discernible from experiments with gnotobiotic animals. Microbial influences upon basic life processes of the host are described in a few examples.

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Concluding from the hitherto known results regarding nutritive influences on the intestinal microbial population, particularly the gramnegative flora, it was found that the human intestinal flora is maintained mainly by endogenous mechanisms. Furthermore, the postnatal intestinal flora shows a weaker stability than that of adults. Also in the period of infancy, influences on the gut flora are most efficient in case of changes within the milieu (ph EH etc.). Cause and importance of longitudinal alterations within the postnatal intestinal flora are obscure.

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Under the conditions of in vitro cultivation, the height of the beta-galactosidase activity of Bifidobacterium spec. is essentially influenced by the composition of the culture medium. The use of gnotobiotic (germ-free and monoassociated with Bifidobacterium longum) rats permitted to differentiate in the chyme between beta-galactosidase activities of mucosal and microbial origin. In germ-free animals, the chyme in the small intestine and the colon contains nearly 10-20% of the activity measured in the mucosa (in each case expressed as g on a wet-weight basis). Monoassociation with B. longum does not affect the lactose-splitting activity of the chyme in the small intestine, but increases the activity of the chyme in the colon to twice the value of the mucosal activity. In the monoassociated animals, feeding of lactose leads to a further multiple increase of the chymal beta-galactosidase activity in the caecum, colon and faeces.

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Maltitol is found to be enzymatically hydrolyzed by the small intestinal mucosa of man, rat, and rabbit and metabolized by everted sacs of rabbit intestine at a moderate rate. On in vivo perfusion of maltitol (15.3 mumol/min) through the small intestine, 19% of the sugar alcohol is digested by gnotobiotic rats. 120 min after stomach intubation of gnotobiotic rats, only 31% of the ingested maltitol is found in the ileum. A daily application of 35 g maltitol to 4 human beings does not influence the parameters of well-being, compatibility and fecal state. It is concluded that maltitol will be digested and utilized by man, rat, and rabbit.

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The stomach wall of the rat is colonised by a dominant lactobacilli flora. The bacteria are localised mainly on the squamous epithelium (Table 1). They adhere tightly, covering the whole surface of the squamous epithelium (Fig. 1). On the secreting epithelium yeasts and bacteria were found only in connection with mucus (Fig. 2). In the present paper a mechanism of adhesion will be discussed. Piliform appendages (PA) were investigated with the aid of electron microscopy between the bacteria and the top cell layer of the epithelium and between the bacterial cells themselves (Fig. 3 and 4). They contain, following indications with scanning and transmission electron microscopy, material from the thin capsulae of acidic mucopolysaccharides, reported by Savage. Lactobacilli isolated from the squamous epithelium and cultivated in vitro are connected by the same piliform appendages. It seems, that the piliform appendages have an affinity to special receptor sites of the bacterial cell wall and also of the gastric epithelium. Lactobacilli situated on the secreting epithelium show piliform appendages, too, but they don't have a tight connection with the epithelial cells, only with the mucus.

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