Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Bile Acid—Mediated Postcholecystectomy Diarrhea

Bile Acid—Mediated Postcholecystectomy Diarrhea Abstract • Diarrhea that develops after cholecystectomy may be due to increased amounts of bile acids presented to the large bowel, a "cholerheic enteropathy." We have studied eight patients to determine the cause for chronic diarrhea after cholecystectomy and found no abnormality other than elevated bile acids in the stool of six of them. All patients with bile acid malabsorption had daily stool weights greater than 200 g and total fecal bile acids three to ten times greater than normal. Patients responded dramatically to treatment with cholestyramine resin. (Arch Intern Med 1987;147:1327-1329) References 1. Hutcheon DF, Bayless TM, Gadacz TR: Postcholecystectomy diarrhea. JAMA 1979;241:823-824.Crossref 2. Aronchick CA, Brooks FP: Anatomy and physiology of the biliary tract , in Berk JE (ed): Bockus Gastroenterology , ed 4. Philadelphia, WB Saunders Co, 1983, pp 3449-3485. 3. Almond HR, Vlahcevic ZR, Bell CC, et al: Bile acid pools, kinetics and biliary lipid composition before and after cholecystectomy. N Engl J Med 1973;289:1213-1216.Crossref 4. Pomare W, Heaton KW: The effect of cholecystectomy on bile salt metabolism. Gut 1973;14:753-762.Crossref 5. Beher WT, Stradnieks S, Lin GJ: Thin-layer separation and quantification of bile acids. Steroids 1982;39:313-323.Crossref 6. Beher WT, Lin GJ, Bajraszewksi F: The determination and excretion of individual human fecal bile acids. Steroids 1984;44:539-547.Crossref 7. Thaysen EH: Diagnostic value of the 14C-cholylglycine breath test. Clin Gastroenterol 1977;6:227-245. 8. Merrick MV, Eastwood MA, Ford MJ: Is bile acid malabsorption underdiagnosed? An evaluation of accuracy of diagnosis by measurement of SeHCAT retention. Br Med J 1985;290:665-668.Crossref 9. Grundy SM, Ahrens EH, Mettinen TA: Quantitative isolation and gasliquid chromatographic analysis of total fecal bile acids. J Lipid Res 1965;6:397-409. 10. Heaton KW, Morris JS: Bitter humour: The development of ideas about bile salts. J R Coll Physicians Lond 1971;6:83-97. 11. Mekhjian HS, Phillips SF, Hofmann AF: Colonic secretion of water and electrolytes induced by bile acids: Perfusion studies in man. J Clin Invest 1971;52:1569-1577.Crossref 12. Small DM, Dowling RH, Redinger RN: The enterohepatic circulation of bile salts. Arch Intern Med 1972;130:552-573.Crossref 13. Heaton KW: Disturbance of bile acid metabolism in intestinal disease. Clin Gastroenterol 1977;6:69-85. 14. Heusinkveld RS, Manning MR, Aristizabal SA: Control of radiation-induced diarrhea with cholestyramine. J Radiat Oncol Biol Phys 1978;4: 687-690.Crossref 15. Hofmann AF: The syndrome of ileal disease and the broken enterohepatic circulation: Cholerheic enteropathy. Gastroenterology 1967;52: 752-757. 16. Thaysen EH, Pedersen L: Idiopathic bile acid catharsis. Gut 1976;17: 965-970.Crossref 17. Binder HJ, Filburn C, Volpe BT: Bile salt alteration of colonic electrolyte transport: Role of cyclic adenosine monophosphate. Gastroenterology 1975;68:503-508. 18. Conley DR, Coyne MJ, Bonorris GG: Bile acid stimulation of colonic adenylate cyclase and secretion in the rabbit. Dig Dis Sci 1976;21:453-458.Crossref 19. Balistreri WF, Heubi JE, Suchy FJ: Bile acid metabolism: Relationship of bile acid malabsorption and diarrhea. J Pediatr Gastroenterol Nutr 1983;2:105-121.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Loading next page...
 
/lp/american-medical-association/bile-acid-mediated-postcholecystectomy-diarrhea-A4rsECJXIB
Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1987.00370070139021
Publisher site
See Article on Publisher Site

Abstract

Abstract • Diarrhea that develops after cholecystectomy may be due to increased amounts of bile acids presented to the large bowel, a "cholerheic enteropathy." We have studied eight patients to determine the cause for chronic diarrhea after cholecystectomy and found no abnormality other than elevated bile acids in the stool of six of them. All patients with bile acid malabsorption had daily stool weights greater than 200 g and total fecal bile acids three to ten times greater than normal. Patients responded dramatically to treatment with cholestyramine resin. (Arch Intern Med 1987;147:1327-1329) References 1. Hutcheon DF, Bayless TM, Gadacz TR: Postcholecystectomy diarrhea. JAMA 1979;241:823-824.Crossref 2. Aronchick CA, Brooks FP: Anatomy and physiology of the biliary tract , in Berk JE (ed): Bockus Gastroenterology , ed 4. Philadelphia, WB Saunders Co, 1983, pp 3449-3485. 3. Almond HR, Vlahcevic ZR, Bell CC, et al: Bile acid pools, kinetics and biliary lipid composition before and after cholecystectomy. N Engl J Med 1973;289:1213-1216.Crossref 4. Pomare W, Heaton KW: The effect of cholecystectomy on bile salt metabolism. Gut 1973;14:753-762.Crossref 5. Beher WT, Stradnieks S, Lin GJ: Thin-layer separation and quantification of bile acids. Steroids 1982;39:313-323.Crossref 6. Beher WT, Lin GJ, Bajraszewksi F: The determination and excretion of individual human fecal bile acids. Steroids 1984;44:539-547.Crossref 7. Thaysen EH: Diagnostic value of the 14C-cholylglycine breath test. Clin Gastroenterol 1977;6:227-245. 8. Merrick MV, Eastwood MA, Ford MJ: Is bile acid malabsorption underdiagnosed? An evaluation of accuracy of diagnosis by measurement of SeHCAT retention. Br Med J 1985;290:665-668.Crossref 9. Grundy SM, Ahrens EH, Mettinen TA: Quantitative isolation and gasliquid chromatographic analysis of total fecal bile acids. J Lipid Res 1965;6:397-409. 10. Heaton KW, Morris JS: Bitter humour: The development of ideas about bile salts. J R Coll Physicians Lond 1971;6:83-97. 11. Mekhjian HS, Phillips SF, Hofmann AF: Colonic secretion of water and electrolytes induced by bile acids: Perfusion studies in man. J Clin Invest 1971;52:1569-1577.Crossref 12. Small DM, Dowling RH, Redinger RN: The enterohepatic circulation of bile salts. Arch Intern Med 1972;130:552-573.Crossref 13. Heaton KW: Disturbance of bile acid metabolism in intestinal disease. Clin Gastroenterol 1977;6:69-85. 14. Heusinkveld RS, Manning MR, Aristizabal SA: Control of radiation-induced diarrhea with cholestyramine. J Radiat Oncol Biol Phys 1978;4: 687-690.Crossref 15. Hofmann AF: The syndrome of ileal disease and the broken enterohepatic circulation: Cholerheic enteropathy. Gastroenterology 1967;52: 752-757. 16. Thaysen EH, Pedersen L: Idiopathic bile acid catharsis. Gut 1976;17: 965-970.Crossref 17. Binder HJ, Filburn C, Volpe BT: Bile salt alteration of colonic electrolyte transport: Role of cyclic adenosine monophosphate. Gastroenterology 1975;68:503-508. 18. Conley DR, Coyne MJ, Bonorris GG: Bile acid stimulation of colonic adenylate cyclase and secretion in the rabbit. Dig Dis Sci 1976;21:453-458.Crossref 19. Balistreri WF, Heubi JE, Suchy FJ: Bile acid metabolism: Relationship of bile acid malabsorption and diarrhea. J Pediatr Gastroenterol Nutr 1983;2:105-121.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1987

References