Fecal bile acid excretion pattern in cholecystectomized patients

Breuer, N.; Jaekel, S; Dommes, P; Goebell, H.

doi:10.1007/bf01303216

Cited by 26 publications

(16 citation statements)

References 48 publications

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“…In particular, it raises the faecal concentration of deoxycholic acid,19 this bile acid being an agent that sensitises the rectum and can cause an urge to defecate 20. However, we found no difference between patients with functioning and non-functioning gall bladders, so other mechanisms—so far unknown—may be operating.…”

Section: Discussioncontrasting

confidence: 56%

Effect of cholecystectomy on bowel function: a prospective, controlled study

Hearing

Thomas

Heaton³

et al. 1999

Gut

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Background-Published estimates of the prevalence of postcholecystectomy diarrhoea derive from retrospective or uncontrolled data. They ignore functional bowel syndromes and possible changes in diet and drug use. Aims-To determine prospectively whether and how often cholecystectomy leads to changes in bowel function and bowel symptoms, especially to liquid stools, over and above any non-specific eVect of laparoscopic surgery. Subjects-Patients: 106 adults undergoing laparoscopic cholecystectomy (85 women, 21 men). Controls: 37 women undergoing laparoscopic sterilisation. Methods-Before and 2-6 months after surgery patients were administered questionnaires about bowel frequency, bowel symptoms, diet, and drugs, and kept records of five consecutive defecations with assessment of stool form or appearance on a seven point scale.Results-In cholecystectomised women, stated bowel frequency increased, on average by one movement a week, and fewer subjects felt that they became constipated. However, records showed no consistent change in bowel frequency, stool form, or defecatory symptoms. Six women reported diarrhoea after the operation but in only one was it clearly new and in her it was mild. Change in dietary fibre intake did not associate with change in bowel function but stopping constipating drugs did in a minority. In women being sterilised there was no consistent change in bowel function. In men having cholecystectomy no consistent changes were observed. Conclusions-In women, cholecystectomy leads to the perception of less constipation and slightly more frequent defecations but short term recordings show no consistent change in bowel function. Clinical diarrhoea develops rarely and is not severe. (Gut 1999;45:889-894)

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Section: Discussioncontrasting

confidence: 56%

Effect of cholecystectomy on bowel function: a prospective, controlled study

Hearing

Thomas

Heaton³

et al. 1999

Gut

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“…Both the small intestine and large intestine possess sulfotransferase activity, although there is considerable variability in the site of expression in the intestine as well as between individual subjects (5). Most studies of sulfated bile acids in feces have given values Ͻ10% (3,47).…”

Section: Bile Acid Class and Group Composition (Percent Total) Of Hmentioning

confidence: 99%

Human cecal bile acids: concentration and spectrum

Hamilton¹,

Xie²,

Raufman³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

234

200

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To obtain information on the concentration and spectrum of bile acids in human cecal content, samples were obtained from 19 persons who had died an unnatural death from causes such as trauma, homicide, suicide, or drug overdose. Bile acid concentration was measured via an enzymatic assay for 3alpha-hydroxy bile acids; bile acid classes were determined by electrospray ionization mass spectrometry and individual bile acids by gas chromatography mass spectrometry and liquid chromatography mass spectrometry. The 3alpha-hydroxy bile acid concentration (mumol bile acid/ml cecal content) was 0.4 +/- 0.2 mM (mean +/- SD); the total 3-hydroxy bile acid concentration was 0.6 +/- 0.3 mM. The aqueous concentration of bile acids (supernatant after centrifugation) was identical, indicating that most bile acids were in solution. By liquid chromatography mass spectrometry, bile acids were mostly in unconjugated form (90 +/- 9%, mean +/- SD); sulfated, nonamidated bile acids were 7 +/- 5%, and nonsulfated amidated bile acids (glycine or taurine conjugates) were 3 +/- 7%. By gas chromatography mass spectrometry, 10 bile acids were identified: deoxycholic (34 +/- 16%), lithocholic (26 +/- 10%), and ursodeoxycholic (6 +/- 9), as well as their primary bile acid precursors cholic (6 +/- 9%) and chenodeoxycholic acid (7 +/- 8%). In addition, 3beta-hydroxy derivatives of some or all of these bile acids were present and averaged 27 +/- 18% of total bile acids, indicating that 3beta-hydroxy bile acids are normal constituents of cecal content. In the human cecum, deconjugation and dehydroxylation of bile acids are nearly complete, resulting in most bile acids being in unconjugated form at submicellar and subsecretory concentrations.

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“…It is unclear whether large proportions of deoxycholic acid are found in the distal colon and rectum due to accumulation of the insoluble acids due to formation while in transit through the colon compared with levels in the proximal colon [88]. Increased levels of deoxycholic acid in the feces of cholecystectomized patients also support the theory that there is an increased exposure of the rectal mucosa to deoxycholic acid [89]. While it has previously been suggested that gallstones and cholecystectomy may have comparable roles in the development of colorectal cancer, gallstone disease appears to have a stronger association.…”

Section: Discussionmentioning

confidence: 99%