Fecal excretion of bile acids: a new technique for studying bile acid kinetics in patients with ileal resection

Woodbury, James F.; Kern, Fred

doi:10.1172/jci106753

Cited by 64 publications

(18 citation statements)

References 23 publications

(17 reference statements)

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“…This confirmed the findings in other studies (9,13,14,18,21). In previous investi gations, it has also been found that in patients with ileal dysfunction, the con centration of bile salts is lower in the afternoon.…”

Section: Discussionsupporting

confidence: 91%

“…In previous investi gations, it has also been found that in patients with ileal dysfunction, the con centration of bile salts is lower in the afternoon. This probably reflects a deple tion of the bile salt pool caused by faecal losses during the day (18,21). The present data showed a significantly lower bile salt concentration after meal 3 compared with previous meals only in patients with functioning gall-bladder and only on a high-fat diet.…”

Section: Discussionsupporting

confidence: 47%

“…The faecal excretion of cholic acid is normally higher than that of chenodeoxycholic acid. This study as earlier studies (15,19,21) has been done using labelled cholic acids only. The effect of a fat-reduced diet on faecal excretion of chenodeoxycholic acids has not been studied.…”

Section: Discussionmentioning

confidence: 77%

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Effects of a Fat-Reduced Diet on the Faecal Excretion of Radioactivity following Administration of 14C-Cholic Acid and on the Duodenal Concentration of Bile Salts in Patients with Ileal Disease

Andersson¹

1976

Ann Nutr Metab

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The fraction of faecal radioactivity excreted after intravenous administration of ¹⁴C-labelled cholic acid decreased in most patients with ileopathy and bile salt malabsorption when the dietary daily fat content was reduced from 100 to 40 g. The decreased faecal cholic acid loss might be due to increased bile salt absorption and decreased emptying of the gall-bladder on the fat-reduced diet. A simplified method to determine the corrected 24-hour excretion of radiologically labelled bile salts is described.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 47%

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Effects of a Fat-Reduced Diet on the Faecal Excretion of Radioactivity following Administration of 14C-Cholic Acid and on the Duodenal Concentration of Bile Salts in Patients with Ileal Disease

Andersson¹

1976

Ann Nutr Metab

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“…Aliquots were removed for measurement of radioactivity as above. Faecal bile acids were measured using a modification (18) of the steroid dehydrogenase method of Woodbury and Kern (20). Results are expressed in milligrams as cholic acid equivalents.…”

Section: Methodsmentioning

confidence: 99%

Effect of Non-Ionic Detergents on the Absorption of Fat and α-Tocopherol in the Rat

Mj¹,

Ms²

1975

Ann Nutr Metab

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Malabsorption of fat and α-tocopherol was induced in rats by feeding cholestyramine and the effect of Tween 80 and Pluronic F 68 was assessed. Tween 80 did not influence the malabsorption of fat or α-tocopherol. Pluronic F68 did not change α-tocopherol absorption but did significantly improve fat absorption. The proportion of radioactivity remaining in the liver 5 days after a labelled dose of α-tocopherol was increased when Tween 80 or Pluronic F68 was present, perhaps indicating increased absorption via the portal vein. Serum cholesterol levels were not affected by the different diets. The greatly increased excretion of faecal bile salts on dietary cholestyramine was unchanged by the detergents.

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“…Less important than in the ileum is the passive diffusion of charged particles through the colon wall (e.g. bile acids, short chain fatty acids, oxalate) [50].…”

Section: How Much Of Which Bowel Segment Can Be Used Without Major Mementioning

confidence: 99%

Bladder reconstruction with bowel after radical cystectomy

et al. 1992

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When a urinary reservoir intended to replace the bladder is made from bowel, it should meet several requirements: good capacity, viscoelasticity and compliance, voluntary control of micturition without residual (infected) urine, a sensation of the filled state and urinary continence. In addition, there should be no major metabolic changes due to malabsorption after bowel resection or due to reabsorption of urinary constituents by the reservoir. In this review several conflicting aspects of bladder reconstruction are addressed: the persisting intestinal peristalsis and urinary incontinence, the volume of the reservoir and its metabolic impact, the bowel segment to be used and the amount that can be resected without the risk of long-term sequelae. Our clinical experience with ileal bladder substitutes in 80 patients underlines the theoretical aspects. After careful instruction, our patients increased the functional capacity of their reservoirs to 500 ml, a precondition for good urinary continence. Provided that the patients were regularly followed-up, the functional, clinical and metabolic results were good. The operative procedure was easy to perform, and no major metabolic sequelae occurred during a maximal observation time of 6 years. Nevertheless, continuing careful follow-up for the detection of potential long-term sequelae, such as disturbances in lipid metabolism or chronic bone demineralisation, are required before definitive statements on the role of intestinal bladder substitutes can be made.The therapeutic benefits of a radical cystectomy for invasive bladder cancer must be considered in the light of the impact of urinary diversion on the quality of life and the associated morbidity. Although today the ileal conduit is still considered to be the standard urinary diversion with * To whom correspondence should be addressed which any other form must be compared, the first attempt at continent urinary drainage, a case of ureterosigmoidostomy, was reported as early as in 1852 by J. Simon [40]. Various forms of intestinal segments were in use for continent urinary reservoirs and bladder substitutes at the turn of this century [46]. High rates of surgical, metabolic and infectious complications have precluded the widespread use of bladder substitutes. However, a better understanding of intestinal physiology, the metabolic implications of the use of the intestine as part 0fthe urinary tract and increasing knowledge of the urodynamic aspects of urinary continence have led to a r~ni~issance of continent diversion first in the 1950s and then again in recent years.The intestinal bladder substitute should be a low-pressure, capacious and high compliance reservoir that can be voided without residual urine as the patient desires. The state of fullness should be appreciable by the patient. The bladder should provide voluntary control of urine as well as continence. Renal functions must be preserved, but at the same time intestinal malabsorption, fluid and electrolyte imbalances and metabolic long-term sequelae caused by...

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Fecal excretion of bile acids: a new technique for studying bile acid kinetics in patients with ileal resection

Cited by 64 publications

References 23 publications

Effects of a Fat-Reduced Diet on the Faecal Excretion of Radioactivity following Administration of <sup>14</sup>C-Cholic Acid and on the Duodenal Concentration of Bile Salts in Patients with Ileal Disease

Effects of a Fat-Reduced Diet on the Faecal Excretion of Radioactivity following Administration of <sup>14</sup>C-Cholic Acid and on the Duodenal Concentration of Bile Salts in Patients with Ileal Disease

Effect of Non-Ionic Detergents on the Absorption of Fat and <i>α</i>-Tocopherol in the Rat

Bladder reconstruction with bowel after radical cystectomy

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