deoxycholic-acid and Biliary-Tract-Diseases

Topics: Bile Acids and Salts; Biliary Tract Diseases; Celiac Disease; Chenodeoxycholic Acid; Cholelithiasis; Cholestasis; Cholic Acids; Colonic Neoplasms; Deoxycholic Acid; Diarrhea; Humans; Intestinal Diseases; Intestine, Small; Lipid Metabolism; Lithocholic Acid; Liver; Liver Circulation; Malabsorption Syndromes; Portal System

Topics: Bile Acids and Salts; Biliary Tract; Biliary Tract Diseases; Cholic Acids; Deoxycholic Acid; Diarrhea, Infantile; Dietary Fats; Duodenum; Fetus; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Intestinal Absorption; Intestinal Mucosa; Jejunum; Lithocholic Acid; Liver; Metabolic Diseases; Solubility; Triglycerides

Topics: Bile Acids and Salts; Biliary Tract Diseases; Blind Loop Syndrome; Celiac Disease; Chenodeoxycholic Acid; Cholelithiasis; Cholesterol; Cholic Acids; Deoxycholic Acid; Diarrhea; Glycine; Humans; Intestinal Absorption; Intestinal Obstruction; Lithocholic Acid; Liver; Liver Circulation; Oxalates; Stomach Ulcer; Taurine

Topics: Bile Reflux; Biliary Tract Diseases; Deoxycholic Acid; Gastritis; Humans; Research Design; Ursodeoxycholic Acid

Intractable epigastric pain associated with nausea and bilious vomiting often follows gastric surgery and has been attributed to reflux of bile and the irritating effects of endogenous bile acids on the gastric remnant. To test the effect of changing bile acid composition of the refluxed material on the symptoms and gastric mucosal histology, 12 patients with symptomatic alkaline reflux gastritis were treated for 1 mo with placebo and for 1 mo with ursodeoxycholic acid, 1000 mg/day. Before treatment, all patients were symptomatic and manifested epigastric pain, nausea, and bilious vomiting. The gastric mucosa was erythematous, friable, and bile stained, and the histology revealed chronic inflammation. No significant change in symptoms was noted during administration of placebo. In contrast, ursodeoxycholic acid treatment resulted in a profound decrease in the intensity and frequency of pain and almost abolished nausea and vomiting. During bile acid therapy the proportion of ursodeoxycholic acid in gastric bile rose to 50% of total bile acids, whereas cholic and deoxycholic acids decreased and chenodeoxycholic acid remained unchanged. The macroscopic and microscopic appearance of the gastric mucosa, however, did not change after 1 mo of ursodeoxycholic acid treatment. These results suggest that increasing the proportion of ursodeoxycholic acid in refluxed gastric bile reduces the pain and frequency of symptoms associated with bile reflux.

Topics: Adult; Aged; Bile Acids and Salts; Bile Reflux; Biliary Tract Diseases; Deoxycholic Acid; Double-Blind Method; Drug Evaluation; Endoscopy; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Hydrogen-Ion Concentration; Male; Middle Aged; Random Allocation; Ursodeoxycholic Acid

Escherichia coli is the species that is most frequently isolated from bile of patients with biliary tract diseases. This study was aimed to investigate any association between resistance and virulence properties of these isolates with occurrence of the diseases. A total of 102 bile samples were obtained from patients subjected to endoscopic retrograde cholangiopancreatography for different biliary diseases. Clinical data were collected and culture of the bile samples was done on selective media. Resistance of characterized Escherichia coli isolates to deoxycholate sodium (0-7%) and nineteen antibiotics was determined and PCR using 16 pairs of primers targeting stx1, stx2, exhA, eae, bfp, agg, pcvd432, lt, st, ipaH, pic, pet, ast, set, sen, and cdtB genes was done. Our results showed a statistically significant association between E. coli colonization and existence of common bile duct and gallbladder stones (p value 0.028). Out of the 22 E. coli strains (22/102) multidrug resistance phenotype was present in 95.45%. None of the strains belonged to common E. coli pathotypes. However, bfp + EhxA-hly, bfp + astA, bfp + EhxA-hly + pic, and EhxA-hly + pic + astA, bfp, and astA genotypes were detected in these strains. bfp (7/22, 31.8%) and astA (5/22, 22.7%) were among most frequent virulence factors in these strains. Results of this study showed significant association between colonization of E. coli and choledocholithiasis. Unusual existence of virulence gene combinations in these strains and their resistance to DOC and multiple classes of antibiotics could be considered as possible causes of their persistence in this harsh microenvironment.

Topics: Bile; Bile Ducts; Biliary Tract Diseases; Choledocholithiasis; Deoxycholic Acid; DNA, Bacterial; Drug Resistance, Multiple, Bacterial; Enterotoxigenic Escherichia coli; Escherichia coli; Escherichia coli Infections; Escherichia coli Proteins; Gallbladder; Genes, Bacterial; Genotype; Humans; Iran; Microbial Sensitivity Tests; Phenotype; Virulence; Virulence Factors

Increases in fecal bile acids may play a role in colorectal carcinogenesis. The authors tested the hypothesis that high concentrations of primary and secondary bile acids are more common in patients with colon cancer than in patients with other gastrointestinal diseases.. In this retrospective study the secondary bile acid deoxycholic acid and the primary bile acid cholic acid were measured in the feces by enzyme-linked immunoabsorbent assay in 63 patients with colorectal cancer, 24 patients with gastric cancer, 11 patients with biliary disorders, and 47 healthy volunteers.. Preoperatively, the mean deoxycholic acid values tended to be higher and the cholic acid values were significantly lower in patients with colorectal cancer than in healthy subjects. Patients with other gastrointestinal diseases had lower deoxycholic acid and cholic acid values than healthy subjects. In healthy subjects the deoxycholic acid to cholic acid ratio ranged from 0.10 to 2.86 (mean, 0.88), but in almost two-thirds, the ratio did not exceed 1. In contrast, the mean preoperative ratio in patients with colorectal cancer was 2.26 (range, 0.06-7.17; P < 0.0001) and tended to be higher in patients with advanced cancer and in those with sigmoid and rectal tumors. If 1.1 is taken as the upper limit of normal for deoxycholic acid to cholic acid ratio, 67 percent of patients with colorectal cancer had an abnormal value preoperatively.. A high deoxycholic acid concentration and deoxycholic acid to cholic acid ratio may be indicators of colorectal cancer. Further study is needed to improve sensitivity and specificity, perhaps by combining fecal bile acid measurements with other tests, and a large prospective trial may be warranted to determine whether these measurements have value in screening for this common cancer.

Topics: Adult; Aged; Aged, 80 and over; Biliary Tract Diseases; Biomarkers, Tumor; Cholic Acid; Colorectal Neoplasms; Deoxycholic Acid; Enzyme-Linked Immunosorbent Assay; Feces; Female; Humans; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Stomach Neoplasms

Topics: Biliary Tract Diseases; Deoxycholic Acid; Drug Tolerance; Humans; Liver Diseases; Radioimmunoassay; Ursodeoxycholic Acid

The value of serum bile acids (SBA) in the diagnosis of hepatobiliary disease has been investigated. A modified GLC method was used, with an overall coefficient of variation of +/- 11% in the control range. Serum was obtained after a 12 hour fast, and two hours after a fatty meal from 73 patients and 14 control subjects. In controls the total fasting SBA of 2.17 +/- 0.86 mumol/l increased significantly (p less than 0.001) to 3.81 +/- 1.14 mumol/l after a meal. All icteric patients had raised SBA, but in 23 anicteric patients there was no significant difference in the detection of chronic liver disease by fasting SBA, postprandial SBA, AST, or gamma GTP. Compared with controls, serum in patients contained proportionately less deoxycholic acid (p less than 0.001), there was proportionately more cholic acid in extrahepatic obstruction (p less than 0.001), and proportionately more chenodeoxycholic acid in patients with cirrhosis, viral hepatitis, and neoplasia (p less than 0.001). In control subjects, the fasting cholic:chenodeoxycholic acid ratio ranged from 0.5-1.0, and differed significantly (p less than 0.001) from patients with extrahepatic obstruction 0.96-3.6, and cirrhosis 0.1-0.5. It is concluded that serum bile acids measured by sensitive methods can provide useful diagnostic information.

Topics: Bile Acids and Salts; Biliary Tract Diseases; Chenodeoxycholic Acid; Cholic Acids; Deoxycholic Acid; Humans; Liver Diseases; Liver Function Tests

A sensitive radioimmunoassay for cholylglycine, chenodeoxycholylglycine, deoxycholylglycine, and sulfolithocholylglycine was established using antibodies obtained from rabbits injected with albumin conjugates of these bile acids. Glycine-conjugated bile acid levels were measured in sera from 25 control subjects and 110 patients who had hepatic disease (alcoholic cirrhosis, hepatitis, cholestasis, and hepatic malignancy). Sulfolithocholylglycine was elevated in the sera of all 110 patients with hepatic disease. Cholylglucine was within normal range in only three. Chenodeoxycholylglycine was elevated in most sera of patients who had hepatitis, cholestasis, or hepatic malignancy. It was normal in most sera of patients who had alcoholic cirrhosis, suggesting that chenodeoxycholic acid may be subject to further biotransformations in these patients. Deoxycholylglycine was elevated in a minority of patients, none of whom had cholestasis. The data suggest that serum bile acids, particularly sulfolithocholylglycine, are a highly sensitive index for hepatic dysfunction.

Topics: Alcoholism; Biliary Tract Diseases; Chenodeoxycholic Acid; Cholestasis; Cholic Acids; Deoxycholic Acid; Glycocholic Acid; Hepatitis; Humans; Lithocholic Acid; Liver Cirrhosis; Liver Diseases; Liver Neoplasms; Radioimmunoassay

Large amounts of bile acid sulfate were found in the urine of patients with hepatobiliary diseases. In patients with acute hepatitis, daily excretion of bile acid into urine was 68.24 plus or minus 51.80 mumoles per day, and the percentage of sulfated bile acid was 83.4 plus or minus 16.7%. In patients with chronic hepatitis and cirrhosis, a slight increase of urinary bile acid was observed (2.89 plus or minus 2.69 and 5.27 plus or minus 4.28 mumoles per day, respectively), and the percentage of sulfated bile acid was 73.9 plus or minus 28.6 and 44.6 plus or minus 30.4%, respectively. In patients with obstructive jaundice, a moderate increase of urinary bile acid was found (32.62 plus or minus 18.35 mumoles per day), and the percentage of sulfated bile acid was 58.3 plus or minus 22.6%. In patients with hepatobiliary diseases, the elevation of both levels of sulfated and nonsulfated bile acids in serum was observed. The percentage of sulfated bile acid was 9% in normal serum, and varied from zero to 82.8% in pathological sera. A remarkable increase of sulfated bile acid was found in patients with obstructive juandice and acute hepatitis, while a slight elevation was found in patients with chronic hepatitis and cirrhosis. Sulfated bile acid in bile was nonexistent or below 0.5% of total bile acid. According to these findings, the increased bile acid in serum of patients with hepatobiliary diseases might be more easily excreted into the urine as sulfated bile acid.

Topics: Bile Acids and Salts; Biliary Tract Diseases; Carbon Radioisotopes; Chenodeoxycholic Acid; Cholestasis; Cholic Acids; Chromatography, Gas; Deoxycholic Acid; Female; Hepatitis; Humans; Liver Cirrhosis; Liver Diseases; Male; Sulfates

Topics: Ampulla of Vater; Animals; Bile; Bile Acids and Salts; Biliary Tract Diseases; Cats; Chenodeoxycholic Acid; Cholic Acids; Chromatography, Thin Layer; Deoxycholic Acid; Disease Models, Animal; Enterobacteriaceae Infections; Gallbladder; Liver; Muscle, Smooth; Perfusion; Pressure; Sodium; Sodium Chloride; Spasm; Time Factors

Topics: Aminohydrolases; Bile Acids and Salts; Biliary Tract Diseases; Biopsy, Needle; Cholic Acids; Chromatography, Gas; Chromatography, Thin Layer; Deoxycholic Acid; Humans; Hydroxides; Liver; Methods; Potassium

Topics: Animals; Bile Acids and Salts; Bile Ducts; Biliary Tract Diseases; Biopsy; Biotransformation; Carbon Radioisotopes; Cholestasis; Cholesterol; Cholic Acids; Chromatography, Gas; Chromatography, Thin Layer; Deoxycholic Acid; Feces; Humans; Lithocholic Acid; Liver; Liver Cirrhosis; Microsomes, Liver; Mitochondria, Liver; Rats

Topics: Adult; Aged; Bile Acids and Salts; Biliary Tract Diseases; Chenodeoxycholic Acid; Cholestasis; Cholic Acids; Chromatography, Gel; Chromatography, Ion Exchange; Deoxycholic Acid; Female; Glycocholic Acid; Humans; Liver Diseases; Liver Function Tests; Male; Middle Aged; Sulfuric Acids; Taurocholic Acid