Influence of cholestasis on absorption of ursodeoxycholic acid

Citation
P. Sauer et al., Influence of cholestasis on absorption of ursodeoxycholic acid, DIG DIS SCI, 44(4), 1999, pp. 817-822
Citations number
40
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
DIGESTIVE DISEASES AND SCIENCES
ISSN journal
0163-2116 → ACNP
Volume
44
Issue
4
Year of publication
1999
Pages
817 - 822
Database
ISI
SICI code
0163-2116(199904)44:4<817:IOCOAO>2.0.ZU;2-V
Abstract
Ursodeoxycholic acid (UDCA) has beneficial effects in cholestatic liver dis eases. Absorption of UDCA is slow and incomplete. In the present study the effect of cholestasis on absorption was evaluated in 10 patients with pancr eatic carcinoma and extrahepatic biliary drainage. At days 3 and 10 after i nsertion of the biliary drain, all patients received 750 mg UDCA in three d ivided doses. On both occasions intestinal absorption of UDCA was determine d to evaluate the influence of cholestasis. Serum bilirubin was used as ind icator of cholestasis. Biliary output of UDCA served as measure of absorpti on and was determined by gas-liquid chromatography. At days 4 and 11 bile c onsisted of less than 2% of UDCA, indicating that UDCA excretion was comple te within 24 hr and no accumulation of UDCA had occurred. After insertion o f the drain, serum bilirubin decreased from 12.2 +/- 2.4 mg/dl at day 3 to 5.4 +/- 0.9 mg/dl at day 10. Biliary secretion of bile acids increased from 2.0 +/- 0.3 to 3.1 +/- 0.4 mmol/day, whereas percentage of ursodeoxycholic acid in bile did not significantly increase (41.1% vs 42.1%). Absorption o f UDCA increased from 39.8 +/- 5.0% to 61.1 +/- 6.2% of the administered do se, indicating an improvement of the absorption rate after decrease of chol estasis by 53.65% (P < 0.05). In conclusion, in severe cholestasis absorpti on of orally administered UDCA is markedly reduced. This may have implicati ons in the treatment of patients with cholestatic disease.