BILIARY LIPID-COMPOSITION IN IDIOPATHIC BILE-ACID MALABSORPTION

Citation
M. Fracchia et al., BILIARY LIPID-COMPOSITION IN IDIOPATHIC BILE-ACID MALABSORPTION, Gut, 43(6), 1998, pp. 812-816
Citations number
37
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
Journal title
GutACNP
ISSN journal
0017-5749
Volume
43
Issue
6
Year of publication
1998
Pages
812 - 816
Database
ISI
SICI code
0017-5749(1998)43:6<812:BLIIBM>2.0.ZU;2-F
Abstract
Background-Chronic diarrhoea is the clinical hallmark of patients pres enting with idiopathic bile acid malabsorption. Its pathogenesis is un known; colonic water secretion can be induced by dihydroxy bile acids, but it is not known whether enrichment of the bile acid pool with the se bile acids occurs in such patients. Furthermore, bile acid malabsor ption is known to affect biliary lipid composition, but no information is available for the idiopathic type. Aims-To verify: (a) whether dia rrhoea in patients with idiopathic bile acid malabsorption is associat ed with enrichment of the bile acid pool with dihydroxy bile acids; an d (b) whether supersaturation with cholesterol of duodenal bile occurs in such patients as a result of chronic bile acid depletion. Patients -Thirteen patients with idiopathic bile acid malabsorption diagnosed a ccording to abnormal (75)SeHCAT test and absence of other organic dise ases, and 23 control subjects. Methods-Bile rich duodenal fluid was co llected during intravenous ceruletide infusion in the fasting state. B iliary lipids were analysed by enzymatic assays and bile acids by high performance liquid chromatography. Results-Patients with idiopathic b ile acid malabsorption had a cholesterol saturation index similar to c ontrols. Bile acid composition showed only a decrease in percentage ch olic acid (29 (2)% versus 36 (2)%; p<0.05); the dihydroxy:trihydroxy b ile acid ratio was similar to controls. Conclusions-Patients with idio pathic bile acid malabsorption do not have an increased risk of formin g cholesterol gallstones. The mechanism of diarrhoea does not seem to depend on an enrichment of the bile acid pool with dihydroxy bile acid s.