Altered Fecal Bile Acid Pattern in Patients with Inflammatory Bowel Disease

Kruis, Wolfgang; Kalek, Horst Dieter; Stellaard, Frans; Paumgartner, Gustav

doi:10.1159/000199367

Cited by 48 publications

(26 citation statements)

References 9 publications

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“…the decreased percentage of deoxycholic acid may be caused by a decreased exposure of cholic acid to microbial enzymes because of a shortened intestinal transit time (30,33).…”

Section: Discussionmentioning

confidence: 99%

Bile composition in patients with ileal resection due to Crohn's disease

Lapidus

Einarsson

1998

Inflamm Bowel Dis

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Patients with Crohn's disease (CD) have an increased risk of developing gallstones, but the mechanisms are unknown. In a previous study, we found a subnormal cholesterol saturation in the bile of patients with short ileal resections due to CD. The aim of this study was to test the hypothesis that (a) CD patients with a long ileal resection have an altered biliary composition and (b) that CD patients with short or long ileal resection have an increased content of bilirubin in their bile. Biliary lipid composition, cholesterol saturation, bile acid pattern, and bilirubin concentration were determined in fasting duodenal bile of 10 CD patients with long ileal resections and in 4 patients with short resections. Ten healthy subjects served as controls. Cholesterol saturation was significantly lower in those CD patients who had a long or short resection compared with the healthy subjects. Bile acid composition in the CD patients was characterized by a significant decrease in the deoxycholic acid fraction and a prominent increase in the ursodeoxycholic acid fraction. The bilirubin concentrations, expressed as micromoles of bilirubin per millimole bile acid, were 45-50% higher in patients who had a long or a short ileal resection compared with healthy controls. Based on these results, CD patients who had had an ileal resection seem not to be at an increased risk of cholesterol gallstone formation but rather at risk of developing pigment stones.

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“…the decreased percentage of deoxycholic acid may be caused by a decreased exposure of cholic acid to microbial enzymes because of a shortened intestinal transit time (30,33).…”

Section: Discussionmentioning

confidence: 99%

Bile composition in patients with ileal resection due to Crohn's disease

Lapidus

Einarsson

1998

Inflamm Bowel Dis

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“…DCA, the other secretory bile acid, also has an extremely low aqueous concentration in the cecum because of its insolubility (2). Thus (37)(38)(39)(40)42).…”

Section: Discussionmentioning

confidence: 99%

Mast cells and histamine contribute to bile acid-stimulated secretion in the mouse colon.

Gelbmann¹,

Schteingart²,

Thompson³

et al. 1995

J. Clin. Invest.

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Certain dihydroxy bile acids cause secretory diarrhea when present in the colonic lumen at inappropriately high concentrations. However, the mechanism underlying the secretagogue activity has not been fully elucidated. Experiments were performed to test whether mast cells and one of their major mediators, histamine, might contribute to the secretory effect. Chenodeoxycholic acid, a secretory bile acid, and ursodeoxycholic acid, a nonsecretory, hydrophilic bile acid, were compared for their ability to induce chloride secretion across segments of mouse colon mounted in Ussing chambers. Chenodeoxycholic acid, but not ursodeoxycholic acid, induced dose-dependent, biphasic chloride secretion that was greater after serosal than mucosal addition and was greater in distal versus proximal colonic segments. The secretory effect of chenodeoxycholic acid was inhibited by H1 histamine receptor antagonists and modified by the cyclooxygenase inhibitor indomethacin. However, it was unaffected by an H2 histamine receptor antagonist or by atropine. Secretory effects of chenodeoxycholic acid were diminished in magnitude and delayed in colonic tissues from mice with a genetic deficiency of tissue mast cells. Concentrations of chenodeoxycholic acid inducing secretion also released histamine from tissue segments. These data indicate that mast cells and histamine-mediated processes contribute significantly to the secretory effects of dihydroxy bile acids in the murine colon. (J. Clin. Invest. 1995. 95:2831-2839

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“…60 One endogenous factor that may affect microbiota composition in the chronically inflamed gut is an impaired bile acid metabolism. Bile acid malabsorption 61,62 and differences in bile acid excretion in conjunction with altered bacterial bile acid conversion 63,64 have been reported in IBD patients. Since bile acids selectively inhibit the growth of intestinal anaerobes but not of aerobic gut bacteria, 65 alterations in intestinal bile acid metabolism may be involved in inflammation-associated changes in gut microbiota.…”

Section: Bacterial Responses Toward the Environmental Conditions In Tmentioning

confidence: 99%