Brief report: length of ileal resection correlates with severity of bile acid malabsorption in Crohn’s disease

Abstract

There was a modest correlation between length of ileal resection and severity of BAM as defined by 75SeHCAT retention values. Response to bile salt sequestrant therapy was not dependent on 75SeHCAT retention values.

Compartmental model to estimate bile acid concentration in different clinical manifestation

“…The intestinal manifestation is taken as case-4 (Figure 6 a), where varying bile acid concentration is estimated due to an increase in the synthesis of bile in the intestine, due to the increased elimination of bile from the intestine to compensate for the huge loss of bile due to ileal resection (4,10) .…”

“…When x 01 = 4 × 10 4 and k e 1 = 0.06, the bile acid concentration was found to be 71.17 mg/ml at 0 min and 48.38 mg/ml at 20 mins in compartment X 1 ; 10.88 mg/ml at 0 min and 6.32 mg/ml at 20 mins in compartment X 3 ; whereas in compartment X 2 the bile acid concentration initially increases from 12 mg/ml to 20.13 mg/ml at 20 mins than gradually decreases to 19.50 mg/ml at 60 mins. The other condition where x 01 = 5×10 4 and k e 1 = 0.08, the bile acid concentration was found to be 88.96 mg/ml at 0 min and 56.46 mg/ml at 20 mins in compartment X 1 ; 10.88 mg/ml at 0 min and 6.56 mg/ml at 20 mins in compartment X 3 ; conversely in compartment X 2 bile acid concentration increases initially from 12 mg/ml to 22.83 mg/ml and after 20 mins it gradually decreases to 21.95 mg/ml at 60 mins. The next assumption considered as x 01 = 6 × 10 4 and k e 1 = 0.1, the bile acid concentration was found to be 106.76 mg/ml at 0 min and 64.17 mg/ml at 20 mins in compartment X 1 , 12 mg/ml at 0 min and 25.40 mg/ml at 20 mins in compartment X 2 than decreases gradually to 24.22 mg/ml at 60 mins.…”

“…The atony of gallbladder functioning or intestinal resection leads to abnormal bile secretion and its circulation, which associate to cause lipid imbalance due to lack of its metabolism and aligning disorder of high risk of cholesterol and bile acid in the systemic circulation (4) . Even though the gallbladder is considered to be not so important organ for survival, but its role in bile acid storage and concentrating its composition following the enterohepatic circulation effectively helps in lipid metabolism and absorption (5) .…”

“…The biliary circulation is essential physiology of the body which regulates lipid digestion in the intestine (24) . As the pathology of the gallbladder and intestine is concerned, the review of literature could assume the change of bile secretion rate in the biliary system, but the bile acid concentration in such pathological condition remains unsolved (4) . The simulation using mathematical tools helps to understand various physiological and pathological conditions of the biliary system.…”

Variation in the length of terminal ileum specimen in right hemicolectomy: a descriptive study

“…The literature is primarily older, and the study populations consist of patients with Crohn's disease rather than colon cancer. [11][12][13][14][15][16] Bile acid malabsorption is well described in the literature regarding resection of terminal ileum. Alterations in bile acid absorption may be associated with both functional and organic types of chronic diarrhoea, [17][18][19] and the variation we found in the length of terminal ileum specimens could theoretically give various clinical types of chronic diarrhoea due to alterations in bile acid absorption.…”