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Hi Marilyn, I'm glad you're getting help from Listmembers -- they've always come through for me, too! And you should be able to get some guidance soon, from the physicians you'll be seeing this week. One point I feel I must make clear, though, as it truly impacts the understanding of how Sinemet works. Your nutritionist has misinformed you. Protein is not broken down into amino acids in the stomach. Stomach acids can certainly denature the shape of the protein chain, but the stomach does not produce any enzymes that will break it into individual amino acids. That can only be done by the proteases, which are released into the small intestine. That's why the small intestine is the locus of importance in the interaction between protein and Sinemet. Best regards to you and your father, Kathrynne Marilyn Gang wrote: > > Hi Kathrynne - > Thank you for your reponse. When I ask enough people I > finally get answers. > > One of the nutritionists reminded me of the wonderful redundancy > of human systems. > > As digestion and enzymes for protein takes place mostly in the stomach, > that is where protein (amino acids) are broken down. But there is > also the protease (also to break down protein) from the pancreas > as well as dipeptidase (peptides and polypeptides are the > components of the amino acids) manufactured in the small intestine. > So even though he does not have a stomach, the aminos are still > being handled to a certain degree. > > So he has digestive help for amino acids from the other organs. > > I appreciate your suggestion on liquid Sinemet and will ask > the doctor about it. It might make things easier. It's also a > reminder to me to see if I can help him with blended foods as they > are easier on the digestion.. > > I am going to see his Internist, neuro and gastroenterologist this > coming week. Whew! I've prepared a report on his hisotry, problems > and recommendations and will give each a copy. I'm curious to see > what they will do with it. > > - Marilyn - > > At 07:07 AM 10/01/1999 -0600, Kathrynne Holden, MS,RD wrote: > >Dear Marilyn, > > > >> 3) Dad's stomach was surgically removed over 20 years ago. > >> Apparently this has happened to a lot of people. As the stomach > >> is where the proteins are broken down in to amino acids, I wonder > >> if the Sinemet - which is made of amino acids -- is being utilized / > >> absorbed / assimilated. > > > >It's a common assumption that digestion takes place in the stomach, > >however, very little digestion occurs there. The stomach's function is > >mostly to grind food (and Sinemet) into tiny particles. The pulverized > >food, including protein, then enters the small intestine. Enzymes in the > >small intestine break up the protein into individual amino acids. These > >aminos compete with levodopa to cross the intestinal wall and get into > >the bloodstream. > > > >Your father's Sinemet will be absorbed in the small intestine; however, > >as his stomach has been removed, his physician might consider (if s/he > >has not already) the use of liquid Sinemet, as this is already > >pulverized and ready to be absorbed. > > > >Best regards, > >Kathrynne > > > >-- > >Kathrynne Holden, MS, RD > >Medical nutrition therapy > >Author: "Eat well, stay well with Parkinson's disease" > >"Parkinson's disease: assessing and managing unique nutrition needs" > >http://www.nutritionucanlivewith.com/ > > > > -- Kathrynne Holden, MS, RD Medical nutrition therapy Author: "Eat well, stay well with Parkinson's disease" "Parkinson's disease: assessing and managing unique nutrition needs" http://www.nutritionucanlivewith.com/