Low-cholesterol diet: enhancement of effect of CDCA in patients with gall stones.

Abstract

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.

Biliary lipid secretion in man

“…Oral administration of the bile acids CDCA [128][129][130][131][132][133][134][135][136][137][138][139][140][141] and UDCA [142-1551 alone or in combination [146,156,157] is associated with decreased cholesterol SI of gallbladder bile and with cholesterol gallstone dissolution in man. It was originally suggested that bile acids might lower cholesterol SI by expanding [I 581 the reduced bile acid pool size in cholesterol gallstone disease [I 171, thus restoring bile acid secretion to normal.…”

Minimum effective dose of chenic acid for gallstone patients: reduction with bedtime administration and low cholesterol diet.

“…6 We have previously shown that the effect of chenic acid (15 mg/kg/day) on saturation index of fasting gallbladder bile is enhanced by bedtime adminis-tration7 and by a low cholesterol diet. 8 The aim of the present study was to assess the effect of these two therapeutic measures on the minimum effective dose of chenic acid, defined as the dose giving mean *Address for reprint requests: Dr T C Northfield, Department of Medicine, St. George's Hospital Medical School, Cranmer Terrace, London SW17 ORE, England. Received for publication 1 September 1981 saturation index of 0-8, in a different group of patients to that previously reported.7'8 A reduction in minimum effective dose would be expected to reduce dose-related diarrhoea,t 3 4 9as well as the cost of treatment.…”

Modified dietary fat intake for treatment of gallstone disease in people of any age

“…We included five trials (Burnand 2016;Lee 1985;Lefkof 1986;Maudgal 1978;. One trial was reported in two references which described the same participants and intervention but di erent outcomes and analyses were reported (Frenkiel…”

“…We had planned to include cross-over trials but to use only data from the first trial period to avoid residual e ects from the intervention (Higgins 2021a; Higgins 2021b). Three were crossover trials and none reported the results from the first trial period separately (Lee 1985;Maudgal 1978;. The findings from these trials were included because the length of each arm of the dietary intervention was at least three weeks (three weeks, Lee 1985; one month, Maudgal 1978; three months, , which was probably long enough for carryover e ects to disappear.…”