. Role of bile salts in fat malabsorption of premature infants. Eighteen premature infants were studied. 9 were fed with human milk and 9 with a modified cow's milk. Subsequent to a 72-hour fat balance, a duodenal intubation was performed on the 14th day of life. Total bile acids were determined in serial duodenal aspirates before and after a milk feed. Bile acid excretion in the faeces during a 72-hour period was also measured.Infants fed with human milk absorbed fat better (mean fat absorption coefficient, 75 %o) than those receiving a cow's milk formula (mean fat absorption coefficient, 60%). In both groups the bile acid concentrations after a meal were often less than that required for the formation of micellar solutions and solubilization of fat (i.e. <2 mmol/l.). With human milk, a reasonable fat absorption occurred even with bile acid levels below the critical micellar concentration. In the infants fed with the cow's milk formula, impaired fat absorption was correlated with low bile acid levels. Infants on human milk excreted less bile acids in the stool (mean, 41 -9 ,umol/kg per 24 hr) than did infants fed with the cow's milk formula (mean, 72 -4,mol/kg per 24 hr). In both groups the faecal loss of bile acids was increased compared with that in older infants and children.
SUMMARY Bile acids were estimated in the duodenum of infants with protracted diarrhoea and compared with those in a control group. Significantly lower levels of total bile acids were found in infants with protracted diarrhoea, a finding which may be due to ileal dysfunction. Low concentrations of total bile acids may contribute to the poor nutritional state of these patients by impairing the normal digestion and absorption of dietary fat and fat-soluble vitamins. The absence of deconjugated bile acids in the duodenal juice of most infants with protracted diarrhoea suggests that they do not contribute significantly to the pathophysiology of this disorder.
ABSTRACT. Challacombe, D. N., Richardson, J. M. and Edkins, S. (Institute of Child Health, University of Birmingham, Birmingham, England). Anaerobic bacteria and deconjugated bile salts in the upper small intestine of infants with gastrointestinal disorders. Acta Paediat Scand, 63: 581, 1974.—Deconjugated bile salts have been reported in the upper small intestine of infants with protracted diarrhoea and secondary mono‐saccharide intolerance. As deconjugated bile salts inhibit monosaccharide transport mechanisms in the small intestine of experimental animals both in vivo and in vitro, they may also cause monosaccharide malabsorption in these infants. In this study infants and children with protracted diarrhoea have been challenged with oral sugar loads to detect patients with glucose or lactose intolerance. The duodenal juice of all infants with protracted diarrhoea was examined by thin layer chromatography and fluonmetry for deconjugated bile salts and cultured anaerobically for bacteria with known deconjugating properties. In addition duodenal juice from infants and children with other gastrointestinal disorders was similarly studied. Deconjugated bile salts and obligate anaerobic bacteria were only associated in two out of thirty samples of duodenal juice, one from an infant with secondary lactose intolerance, and one from an infant with unexplained failure to gain weight. The absence of deconjugated bile salts in the duodenum of two infants with secondary monosaccharide intolerance and from other infants with protracted diarrhoea, does not support the suggestion that the action of deconjugated bile salts on the small intestinal mucosa, is an important causative factor in these disorders.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.