Effect of cimetidine and pancreatic enzymes on serum and fecal bile acids and fat absorption in cystic fibrosis

Boyle, Brian J.; Long, William B.; Balistreri, William F.; Widzer, Steven J.; Huang, Nancy Ν.

doi:10.1016/0016-5085(80)90776-3

Cited by 60 publications

(27 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The low duodenal pH associated with CF leads not only to a poor release of enteric-coated pancreatic enzymes but also to a decreased lipolytic activity of lipase and bile acid precipitation (25)(26)(27). H2-receptor antagonists and prostaglandin E2 have been used with the hope to reverse the above process, but results on steatorrhoea have been controversial (13)(14)(15)(16)(17). Insufficient inhibition of gastric acid production could be the cause of these failures.…”

Section: Discussionmentioning

confidence: 99%

“…As CF patients have a low duodenal pH probably responsible for fat maldigestion (12), inhibition of gastric acid production could improve absorption. The reported effects of H2-receptor antagonists and prostaglandin E2 on steatorrhoea have, however, been variable (13)(14)(15)(16)(17). Insufficient inhibition of gastric acid secretion could be responsible for these unconvincing results.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effects of a proton‐pump inhibitor in cystic fibrosis

et al. 1998

View full text Add to dashboard Cite

Tran TMD, Van den Neucker A, Hendriks JJE, Forget P, Forget P-Ph. Effects of a proton-pump inhibitor in cystic fibrosis. Acta Paediatr 1998; 87: 553-8. Stockholm. ISSN 0803-5253 Most children with cystic fibrosis (CF) show persisting steatorrhoea even when treated with pancreatic enzyme. As a low duodenal pH could be responsible for this persisting fat loss, we evaluated the effects of a proton-pump inhibitor (lansoprazole) on both steatorrhoea and growth parameters in 15 CF patients, aged 3.1-22.6 y. Acid steatocrit, anthropometry and dual-energy X-ray absorptiometry were used to evaluate steatorrhoea and the nutritional status before, during and 3 months after stopping lansoprazole treatment (15 mg/d for 3 months). Mean Ϯ SD acid steatocrit values decreased from 37.1 Ϯ 8.8% to 28.5 Ϯ 10.6% ( p ¼ 0:02). Significant mean Z-score improvements were found for weight (þ0:14; p ¼ 0:02), height (þ0:15; p ¼ 0:03), subscapular (þ0:61; p ¼ 0:003), supra-iliac (þ0:8; p ¼ 0:002) and the sum of the four measured skinfolds (þ0:61; p ¼ 0:002). Z-scores deteriorated again after stopping lansoprazole. Fat mass and bone mineral content increased significantly on lansoprazole ( p ¼ 0:008 and p ¼ 0:005, respectively). We conclude that lansoprazole as adjuvant therapy significantly improves both steatorrhoea and the nutritional status in CF children who maintain steatorrhoea while on pancreatic enzymes. ٖ Acid steatocrit, cystic fibrosis, nutritional condition, proton-pump inhibitor P-Ph Forget,

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Effects of a proton‐pump inhibitor in cystic fibrosis

et al. 1998

View full text Add to dashboard Cite

show abstract

“…Bile m i d pool and excri.tion As already mentioned, the first disturbance in bile acid metabolism to be reported in C F was an increase in fecal excretion (3)(4)(5)(6). Children with CF excreted similar amounts of bile acids as children after extensive ileal resection (3).…”

Section: Bile Acid Metabolism In Cystic Fibrosismentioning

confidence: 93%

“…Sodium bicarbonate supplements did not alter bile acid malabsorption. but cimetidine was effective in one study (6,26,27,40).…”

Section: Factors Contributing To B I L E Acid Malabsorption In C Fmentioning

confidence: 97%

See 1 more Smart Citation

Bile Acid Metabolism in Children with Cystic Fibrosis

Weber

Roy

1985

Acta Paediatrica

View full text Add to dashboard Cite

. Recycling of bile acids through the enterohepatic cycle is very efficacious. Bile acids contribute to bile formation and, by forming micelles, participate in lipid solubilization and absorption. The small fraction which escapes in the feces, is synthesized daily by the liver to compensate for losses. In CF, bile acid malabsorption has been documented; these large losses are accompanied by an interruption in the enterohepatic circulation with concomitant reduction in bile acid pool and disturbances in biliary composition. The various intraluminal factors implicated in bile acid malabsorption include: unhydrolysed triglycerides and phospholipids, precipitation of bile acids in acidic duodenal content, adsorption to residues and modification of colonic microflora. A defect in bile acid ileal uptake has also been advocated. These disturbances in bile acid metabolism associated with CF might lead to aggravation of diarrhea and steatorrhea, cholelithiasis and perhaps liver disease.

show abstract

Drug therapies for reducing gastric acidity in people with cystic fibrosis

Ng¹,

Francini²

2003

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Effect of cimetidine and pancreatic enzymes on serum and fecal bile acids and fat absorption in cystic fibrosis

Cited by 60 publications

References 16 publications

Effects of a proton‐pump inhibitor in cystic fibrosis

Effects of a proton‐pump inhibitor in cystic fibrosis

Bile Acid Metabolism in Children with Cystic Fibrosis

Drug therapies for reducing gastric acidity in people with cystic fibrosis

Contact Info

Product

Resources

About