Cholestyramine Influences Meal-Stimulated Pancreaticobiliary Function and Plasma Cholecystokinin Independent of Gastric Emptying and Food Digestion

Abstract

Thimister PWL, Hopman WPM, Loualidi A, Rosenbusch G, Willems HL, Trijbels FJM, Jansen JBMJ. Cholestyramine influences meal-stimulated pancreaticobiliary function and plasma cholecystokinin independent of gastric emptying and food digestion. Scand J Gastroenterol 1997;32:778-784.Background: Cholestyramine enhances gallbladder emptying and plasma cholecystokinin responses to oral ingestion of a mixed meal. It is not known whether this effect occurs independently of alterations in gastric emptying or maldigestion of nutrients. Methods: We perfused 15 g of an amino acid meal intraduodenally for 60 min in seven healthy volunteers, once with and once without cholestyramine, Intraduodenal perfusion of saline with or without cholestyramine (6 g/h) was started 60 min before the amino acid meal and continued for 2h. Results: Cholestyramine markedly enhanced the incremental plasma cholecystokinin response to the meal from 36 ± 12 to 139 ± 25pmol/1 -60min (P < 0.005), incremental amylase output from 2.4 ± 0.7 to 5.7 ± 0.7 kU/h (.P < 0.05), and incremental integrated gallbladder contraction from 1948 ± 235 to 2840 ± 189% * 60 min (P < 0.05). Conclusion: The enhanc ing effect of cholestyramine on postprandial gallbladder contraction, pancreatic enzyme secretion, and plasma cholecystokinin release is not dependent on gastric emptying rates or appropriate digestion of nutrients.

The Cholestyramine-induced Decrease of PYY Postprandial Response is Negatively Correlated with Fat Mass in Obese Women

“…To the best of our knowledge, this is the fi rst time that a study demonstrates the cholestyramine-induced inhibition of postprandial PYY secretion, which was limited at 15, 30, and 60 min Humans, Clinical after food intake. There is only one study, in which cholestyramine, administered to healthy subjects intraduodenally perfused with an amino acid meal, was reported to enhance the release of pancreatic polypeptide (PP), a gastrointestinal peptide structurally similar to PYY, having, nevertheless, diff erent functions [ 22 ] . The mechanism by which cholestyramine reduced the plasma PYY response to the high-fat meal remains speculative.…”

Regulation of cholecystokinin secretion in humans

“…To this point, cholestyramine was shown not only to enhance plasma CCK responses to a mixed meal but also to increase gallbladder contraction. 61 These effects were independent of the effects on gastric emptying or maldigestion. Because cholestyramine enhanced both CCK release and gallbladder contraction, its effects were likely due to the direct influences of bile acids rather than being due to indirect effects on the gallbladder.…”

Colestyramine slows gastric emptying of liquids and reduces appetite in healthy subjects

“…One candidate is colestyramine, a synthetic bile acid‐sequestering particulate resin formerly used as a cholesterol‐lowering agent 5 . There is evidence to suggest that colestyramine enhances CCK secretion 6–8 and crucially, as it is not absorbed, it can have no potentially confounding postabsorptive effects 9 …”