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Summary and conclusionsFifteen patients with gall stones who were taking chenodeoxycholic acid (CDCA) 15 mg/kg at bedtime participated in two separate experiments to investigate the effects of altering sterol intake on the cholesterol saturation index (SI) of fasting gall-bladder bile. In experiment I the 15 patients on an unrestricted diet had a SI of 0 87 -0 04 (mean L SE of mean), which fell to 0 75 +0 04 after one week in hospital on a diet of 100 mg cholesterol daily. In experiment II seven of the patients were given four different dietary regimens lasting one month each in random order as outpatients. On a diet of 600 mg of cholesterol daily the mean SI was 0-72 0-05, which fell to 0 67 0 05 when the patients were put on a 100 mg cholesterol diet. The addition of plant sterols (3 g daily) to both diets raised the mean SIs to 0 80±0 05 and 0 77 0 05 respectively. The percentage CDCA in bile was unaffected by alterations in the cholesterol and plant sterol intakes.We conclude that a low-cholesterol diet but not a high intake of plant sterols enhances the effect of CDCA in patients with gall stones.

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