Abstract
Bile acid fecal excretion and dihydroxy bile acid concentration in the fecal water of patients with large (N=6) and small (N=8) ileal resection, colectomy (N=5), and healthy controls (N=10) have been studied in order to evaluate the degree of bile acid malabsorption and the occurrence of bile acid diarrhea in intestinal resections of different extent. Bile acid malabsorption was severe in large ileal resections, mild in small ones, and slight in colectomy. The fecal pH seems to be a limiting factor in the occurrence of a bile acid diarrhea, playing a critical role in determining the dihydroxy bile acid solubility in the fecal water. These results seem to suggest that the bile acids may induce water secretion in the colon not only in small but also in large ileal resections.
Similar content being viewed by others
References
Hofmann AF: The enterohepatic circulation of bile acids in man. Clin Gastroenterol 6:3–24, 1977
Dietschy JM: Mechanism for intestinal absorption of bile acids. J Lipid Res 9:297–309, 1968
Weiner IM, Lack L: Bile acid absorption: Enterohepatic circulation.In Handbook of Physiology, Section 6, Alimentary Canal, Vol 3. CF Code, W Heidel (eds). Baltimore, Williams and Wilkins, 1968, pp 1439–1455
Krag E, Phillips SF: Active and passive bile acid absorption in man. Perfusion studies of the ileum and jejunum. J Clin Invest 53:1686–1694, 1974
Holt PR: Intestinal absorption of bile salts in the rat. Am J Physiol 207:1–7, 1964
Samuel P, Saypol E, Meilman E, Mosbach EH, Chafidazeh M: Absorption of bile acids from the large bowel in man. J Clin Invest 47:2070–2078, 1968
Hofmann AF: The syndrome of ileal disease and broken enterohepatic circulation: Cholereic enteropathy. Gastroenterology 52:752–757, 1967
Hofmann AF: Bile acid malabsorption caused by ileal resection. Arch Intern Med 130:597–605, 1972
Heaton KW: Disturbances of bile acid metabolism in intestinal disease. Clin Gastroenterol 6:69–89, 1977
Hofmann AF, Pooley JR: Role of bile acid malabsorption in pathogenesis of diarrhea and steatorrhea in patients with ileal resection. I. Response to cholestyramine or replacement of dietary long chain triglyceride by medium chain triglyceride. Gastroenterology 62:918–934, 1972
Mekhjian HS, Phillips SF: Perfusion of the canine colon with unconjugated bile acids. Effect on water and electrolyte transport, morphology and bile acid absorption. Gastroenterology 59:120–129, 1970
Mekhjian HS, Phillips SF, Hofmann AF: Colonic secretion of water and electrolytes induced by bile acids: Perfusion studies in man. J Clin Invest 50:1567–1577, 1971
Small DM: The physical chemistry of cholanic acids.In The Bile Acids. Chemistry, Physiology and Metabolism. PP Nair, D Kritchevsky (eds). New York, Plenum Press, 1971, p 249
Hofmann AF: Bile acids, diarrhea and antibiotics: Data speculation and unifying hypothesis. J Infect Dis 135:S267–7, 1977
Fromm H, Hofmann AF: Breath test for altered bile acid metabolism. Lancet 2:621–625, 1971
Roda A, Roda E, Aldini R, Festi D, Mazzella G, Sama C, Barbara L: Determination of14CO2 in breath and14C in stool after oral administration of cholyl[1-14C]glycine: Clinical application. Clin Chem 23:2127–2132, 1977
Thaysen EH: Diagnostic Value of the14C cholylglycine breath test. Clin Gastroenterol 6:227–245, 1977
Grundy SM, Ahrens EH, Miettinen TA: Quantitative isolation of gas-liquid chromatographic analysis of total faecal bile acids. J Lipid Res 6:397–410, 1965
Lundh G: Intestinal digestion and absorption after gastrectomy. Acta Chir Scand Suppl 231:83, 1958
van de Kamer JH, ten Bokkel Huinik H, Weyers HA: Rapid method for the determination of fat in feces. J Biol Chem 177:347–355, 1949
Meihoff WE, Kern F Jr: Bile salt malabsorption in regional ileitis, ileal resection, and mannitol induced diarrhea. J Clin Invest 47:261–267, 1968
Mekhjian HS, Phillips SF, Hofmann AF: Colonic absorption of unconjugated bile acids: Perfusion studies in man. Dig Dis Sci 24:545–550, 1979
Kern F: Disappearance of deoxycholic acid after ileal resection. Gastroenterology 64:123–127, 1973
Angelin B, Einarsson K, Hellström K: Evidence for the absorption of bile acids in the proximal small intestine of normo- and hyperlipidaemic subjects. Gut 17:420–425, 1976
Angelin B, Björkem I: Postprandial serum bile acids in healthy man. Evidence for differences in the absorptive pattern between individual bile acids. Gut 18:606–609, 1977
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Aldini, R., Roda, A., Festi, D. et al. Bile acid malabsorption and bile acid diarrhea in intestinal resection. Digest Dis Sci 27, 495–502 (1982). https://doi.org/10.1007/BF01296727
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01296727