The role of altered bile acid metabolism in the steatorrhea of experimental blind loop.

Bile salt regulation of fatty acid absorption and esterification in rat everted jejunal sacs in vitro and into thoracic duct lymph in vivo

“…However, Tabaqchali, Hatzioannou, and Booth (10) have reported also that decreased concentrations of conjugated bile acids were found in the proximal small gut in nine patients with steatorrhea and bacterial overgrowth in the upper small gut; the steatorrhea was lessened in one patient by feeding supplemental taurocholate. These results supported the previous work in dogs by Kim, Spritz, Blum, Terz, and Sherlock (11), who from similar findings suggested that deficient concentrations of conjugated bile salts were more important in producing fat malabsorption than the accumulation of free bile acids.…”

“…Our studies are relevant to the conditions seen clinically (10) in the blind loop syndrome where the levels of conjugated bile salts may be reduced well below the CMC and unstable emulsions would be expected to occur. Although feeding extra taurocholate reduced steatorrhea of the blind loop syndrome (10,11), a more practical approach to the problem in man seems to be elimination of the excess bacteria through relieving the intestinal stasis by appropriate surgical therapy, or reducing the bacterial population by suitable antibiotic treatment.…”

Malabsorption syndrome with and without small intestinal bacterial overgrowth: A study on upper‐gut aspirate using 1H NMR spectroscopy

“…On the other hand, a significant correlation was found between the amount of unconjugated bile acids and the amount of fecal fat excretion. This appears to suggest the pathophysiological significance of unconjugated bile acids in causing malabsorption of fat (29). The alteration of normal bile salt metabolism by bacterial deconjugation within the lumen could cause steatorrhoea in several ways.…”

Intraluminal Precipitation of Bile Acids in Stagnant Loop Syndrome

“…Bacterial deconjugation of bile acids occurs in the small intestinal lumen of animals with surgically created blind loops (Donaldson, 1965;Kim et al, 1966) and of patients Departments of Medicine and Biochemistry, Guy's Hospital, London SEI 9RT T. C. NORTHFIELD, M.D., M.R.C.P., Senior Registrar with the stagnant loop syndrome (Donaldson, 1965;Tabaqchali and Booth, 1966). Free (unconjugated) bile acids inhibit the uptake and esterification of fatty acids by small intestinal slices in vitro (Dawson and Isselbacher, 1960), but this does not appear to be the mechanism of fat malabsorption in vivo (Gallagher et al, 1968;Cheney et al, 1970;Clark et al, 1970).…”