deoxycholic-acid and Diarrhea

Topics: Animals; Calcinosis; Chenodeoxycholic Acid; Cholelithiasis; Cholesterol; Colonic Neoplasms; Cost-Benefit Analysis; Deoxycholic Acid; Diarrhea; Female; Humans; Liver; Macaca mulatta; Male; Transaminases; Ursodeoxycholic Acid

Topics: alpha 1-Antitrypsin; Bacterial Toxins; Cholestyramine Resin; Colonic Diseases; Deoxycholic Acid; Diarrhea; Humans; Immunoglobulin G; Iodine Radioisotopes; Malabsorption Syndromes; Prostaglandins; Protein-Losing Enteropathies; Serum Albumin; Vasoactive Intestinal Peptide; Water-Electrolyte Imbalance

Cholesterol gallstone formation occurs in three stages. First, the bile must be saturated with cholesterol, thereby allowing cholesterol crystals to form. Then, nucleation and growth of the gallstone can occur, although little is known about these latter two stages. Therapy for dissolution of gallstones is directed at desaturating the bile. Chenodeoxycholic acid (CDCA), the most extensively tested agent, is successful in dissolving 60 per cent of radiolucent gallstones; however, long-term safety remains to be demonstrated. Ursodeoxycholic acid (UDCA), the 7 beta epimer of CDCA, is a promising agent for cholesterol gallstone dissolution, but it, other potential agents, and dietary manipulations require more extensive study. An important problem, the prevention of recurrence of gallstones after dissolution, also needs resolution. Medical dissolution probably will be applicable as an alternative to cholecystectomy for most patients with radiolucent gallstones, but the specific relative indications remain to be determined. A variety of modalities, both medical and surgical, are being used for the treatment of retained or reformed bile duct stones. These include T-tube infusions, oral CDCA, and extraction either through the T-tube tract or after endoscopic papillotomy. Further studies, including controlled trials, are necessary to determine the relative indications for these methods.

Topics: Animals; Bile; Bile Acids and Salts; Chemical and Drug Induced Liver Injury; Chenodeoxycholic Acid; Cholelithiasis; Cholesterol; Contraceptives, Oral, Synthetic; Deoxycholic Acid; Diarrhea; Enterohepatic Circulation; Estrogens; Female; Gallstones; Humans; Liver; Male; Phosphatidylcholines; Pregnancy; Recurrence; Risk

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 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

The efficacy and safety of ursodeoxycholic acid for the treatment of primary sclerosing cholangitis were evaluated in a prospective, randomized, double-blind, placebo-controlled trial. Fourteen patients with primary sclerosing cholangitis documented by cholestatic serum enzyme pattern, liver histological appearance and endoscopic retrograde cholangiography were included in the trial. Six patients received ursodeoxycholic acid (13 to 15 mg/kg body wt/day), and eight patients received placebo. Two patients had to be withdrawn from the study, one because of UDCA-related diarrhea and the other because of worsening of the disease during placebo treatment. Patients in the ursodeoxycholic acid group improved significantly during 1 yr of treatment with respect to serum levels of bilirubin (median = -50%), alkaline phosphatase (median = -67%), gamma-glutamyltransferase (median = -53%), AST (median = -54%) and ALT (median = -36%) compared with the placebo group, but not with respect to serum levels of hydrophobic bile acids. During ursodeoxycholic acid treatment, histopathological features also improved significantly, as evaluated by multiparametric score. Expression of human leukocyte antigen class I molecules appeared to be markedly reduced on liver cells after ursodeoxycholic acid treatment. We conclude that ursodeoxycholic acid is beneficial in reducing disease activity in patients with primary sclerosing cholangitis.

Topics: Adolescent; Adult; Alanine Transaminase; Alkaline Phosphatase; Aspartate Aminotransferases; Chenodeoxycholic Acid; Cholangitis, Sclerosing; Cholic Acid; Cholic Acids; Deoxycholic Acid; Diarrhea; Double-Blind Method; Female; Humans; Liver; Male; Middle Aged; Prospective Studies; Ursodeoxycholic Acid

Ursodeoxycholic acid, 250 to 300, 500 to 600, or 900 to 1000 mg/d, was given orally for 6 to 38 months to 53 patients with cholesterol gallstones and functioning gallbladders. Forty-two patients had greater than 50% reduction in gallstone volume, number, or both, without apparent dose dependence and 27 of these patients had complete gallstone dissolution. Results of laboratory studies including liver function tests were not affected adversely and biliary lithocholic acid concentration did not increase during therapy. Most biliary symptoms seemed to disappear within 3 months and no patient developed diarrhea. Large diameter and increased number of gallstones were found to hinder dissolution. The percentage of biliary ursodeoxycholic acid increased with increasing dose and reached a maximum of 50% to 60% of total bile acids at a dose of about 10 to 12 mg/kg body weight. d. Biliary lithogenic index was reduced significantly during treatment with ursodeoxycholic acid, 500 to 600 and 900 to 1000 mg/d. Thus, ursodeoxycholic acid appears to be a safe and effective alternative to surgery in selected patients with gallstones.

Topics: Bile Acids and Salts; Cholelithiasis; Cholesterol; Clinical Trials as Topic; Deoxycholic Acid; Diarrhea; Dose-Response Relationship, Drug; Female; Humans; Lithocholic Acid; Liver; Male; Middle Aged; Random Allocation; Time Factors; Ursodeoxycholic Acid

The cholelitholytic action of ursodeoxycholic acid (UDCA) was investigated by a double-blind clinical trial. The trial started with 151 subjects all confirmed by radiographic examination as having radiolucent gallstones in a functioning gallbladder. The subjects were divided into three groups receiving 600 mg/day of UDCA, 150 mg/day of UDCA, and placebo (lactose) per day, respectively. Seventy-nine cases were classed as dropouts or were excluded due to incomplete follow-up or inadequate patient selection, and the data on the remaining 72 cases were analyzed. After 6--12 mo of treatment, dissolution of decrease in size or number of stones occurred in 10 of the 29 cases in the 600 mg/day group (34.5%), 4 of 23 cases in the 150 mg/day group (17.4%), and 1 of 20 cases in the control group (5.0%). For those cases with noncalcified, less than 15 mm in diameter, and floating stones, efficacy increased to 83.3% in the 600 mg/day group. Lithogenic index of bile defined by Thomas and Hofmann became unsaturated after treatment in the 600 mg/day group. Neither diarrhea nor hepatic toxicity was noted. The results indicate that UDCA is a safe and effective litholytic agent.

Topics: Bile; Cholelithiasis; Cholesterol; Clinical Trials as Topic; Deoxycholic Acid; Diarrhea; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Liver Function Tests; Male; Middle Aged; Phospholipids; Time Factors; Ursodeoxycholic Acid

Histoplasmosis is an invasive mycosis caused by inhalation of the spores of dimorphic fungi Histoplasma capsulatum. The disease manifests in the lung as acute or chronic pulmonary histoplasmosis and in severe cases gets disseminated in multiple organs like skin, adrenal gland, central nervous system, lymph node, liver, spleen, bone marrow, and gastrointestinal tract. It occurs most commonly in immunodeficient patients like HIV-positive patients and transplant recipients, while immunocompetent hosts are affected rarely. In cases of gastrointestinal histoplasmosis, the samples are collected for culture and biopsy should be sent for histopathological examination for definitive diagnosis. We conducted a retrospective study of colonic biopsies performed in the department of gastroenterology in a tertiary care hospital of north India from January 2014 to December 2015. Five cases of colonic histoplasmosis were diagnosed on histopathology out of which 4 patients were from north India while 1 patient was from Myanmar. The patients presented with various complaints, including loose stools, diarrhea, altered bowel habits, and gastrointestinal bleeding. The prognosis is very good after early and aggressive treatment while the disease is fatal if it remains untreated. In our study, 2 patients died within few days of diagnosis due to delay in the diagnosis, dissemination, and associated complications. Other patients were started on amphotericin B deoxycholate and are under follow-up. An early diagnosis of gastrointestinal histoplasmosis is important as appropriate treatment leads to long-term survival while untreated cases are almost fatal.

Topics: Adult; Aged; Amphotericin B; Antifungal Agents; Biopsy; Colon; Colonoscopy; Deoxycholic Acid; Diarrhea; Drug Combinations; Female; Follow-Up Studies; Gastrointestinal Hemorrhage; Histoplasma; Histoplasmosis; Humans; India; Male; Middle Aged; Prognosis; Retrospective Studies; Time Factors

Topics: Adenosine Monophosphate; Aminopyridines; Anti-Asthmatic Agents; Antibodies, Monoclonal, Humanized; Anticoagulants; Antiemetics; Benzodioxoles; Cholagogues and Choleretics; Cystic Fibrosis Transmembrane Conductance Regulator; Deoxycholic Acid; Diarrhea; Drug Approval; Imidazoles; Irritable Bowel Syndrome; Spiro Compounds

About one-third of patients with IBS-diarrhoea (irritable bowel syndrome-D) have evidence of increased bile acid synthesis or excretion.. To assess effects of the bile acid sequestrant, colesevelam, on faecal excretion of BAs, hepatic BA synthesis and diarrhoea in IBS-D; to appraise whether individual or random stool samples accurately reflect 48-h total faecal bile acid excretion and proportions of the main bile acids excreted and to study the faecal fat excretion in response to colesevelam.. A single-centre, unblinded, single-dose trial of effects of colesevelam, 1875 mg [3 tablets (625 mg tablets)] orally, twice daily, for 10 days on total 48-h faecal bile acid excretion and fasting serum C4 (7α-hydroxy-4-cholesten-3-one; surrogate of hepatic bile acid synthesis). Stool diaries documented bowel functions for 8 days prior and 8 days during colesevelam treatment. Stool 48-h samples and fasting serum were collected for faecal fat, faecal bile acid and serum C4.. Colesevelam was associated with significantly increased faecal total bile acid excretion and deoxycholic acid excretion, increased serum C4 and more solid stool consistency. There was a significant inverse correlation between number of bowel movements per week and the total bile acid sequestered into stool during the last 48 h of treatment. Random stool samples did not accurately reflect 48-h total or individual faecal bile acid excretion. Sequestration of bile acids by colesevelam did not increase faecal fat.. Colesevelam increases delivery of bile acids to stool while improving stool consistency, and increases hepatic bile acid synthesis, avoiding steatorrhoea in patients with IBS-D. Overall effects are consistent with luminal bile acid sequestration by colesevelam.

Topics: Adult; Allylamine; Bile Acids and Salts; Cholestenones; Colesevelam Hydrochloride; Deoxycholic Acid; Diarrhea; Feces; Female; Gastrointestinal Agents; Humans; Irritable Bowel Syndrome; Middle Aged

The growth and appearance of 115 stock Salmonella isolates on a new formulation of CHROMagar Salmonella (CAS) medium were compared to those on xylose-lysine-desoxycholate agar (XLD), Salmonella-Shigella agar (SS), and Hektoen enteric agar (HEA) media. CAS medium was then compared prospectively to XLD and SS for the detection and presumptive identification of Salmonella strains in 500 consecutive clinical stool samples. All stock Salmonella isolates produced typical mauve colonies on CAS medium. Nine Salmonella strains were isolated from clinical specimens. The sensitivities for the detection of salmonellae after primary plating on CAS medium and the combination of XLD and SS after enrichment were 100%. The specificity for the detection of salmonellae after primary plating on CAS medium (83%) was significantly (P < 0.0001) higher than that after primary plating on the combination of SS and XLD media (55%) (a 28% difference in rates; 95% confidence interval, 23.0 to 34%). Twenty-nine non-Salmonella organisms produced mauve colonies on CAS medium, including 17 Candida spp. (59%) and 8 Pseudomonas spp. (28%). These were easily excluded as salmonellae by colony morphology, microscopic examination of a wet preparation, or oxidase testing. One biochemically inert Escherichia coli isolate required further identification to differentiate it from Salmonella spp. The use of plating on CAS medium demonstrated high levels of sensitivity and specificity and reduced the time to final identification of Salmonella spp., resulting in substantial cost savings. It can be recommended for use for the primary isolation of Salmonella spp. from stool specimens. Other media (e.g., XLD) are required to detect Shigella spp. concurrently.

Topics: Agar; Bacteriological Techniques; Chromogenic Compounds; Culture Media; Deoxycholic Acid; Diarrhea; Feces; Humans; Lysine; Salmonella; Salmonella Infections; Sensitivity and Specificity; Shigella; Xylose

Humans, after extensive ileal resection, frequently suffer from diarrhoea, which may be due to an increased delivery of deoxycholate (DOC) to the large intestine. In the frog skin the addition of DOC (0.5 mM) to the apical side induced the activation of amiloride-sensitive Na+ channels and an increase in the unidirectional Cl- fluxes. Here we used two established cell lines (A6 and Caco2) to study the effect of DOC on ion channels at cell and membrane level using the patch-clamp technique. In A6 cells subcultured directly on Petri dishes and studied in the whole-cell configuration, DOC induced an increase in cell conductance of 110.3 +/- 4 pS pF-1 (N = 8) which was reduced to 89 +/- 14 pS pF-1 (N = 8) by the addition of DIDS (0.5 mM), The absolute values of these two effects were not statistically different (P < 0.2). In Caco2 cells, the addition of DOC (0.5 mM) induced, after 1 min, an increase in cell conductance of 583 +/- 16 pS pF-1 (N = 8) which was reduced to 560.4 +/- 16 pS pF-1 (N = 8) by DIDS (0.5 mM) and N-phenylanthranilic acid (DPC; 0.5 mM). The two values were not statistically different (P < 0.4). In Caco2 cells subcultured under the same conditions, DOC induced an increase in cell conductance of 1710 +/- 64 pS pF-1 (N = 6). Subsequent addition of amiloride (0.1 mM) reduced the cell conductance to 1558 +/- 33 pS pF-1 (N = 6). These two mean values were statistically different allowing for an error of the second kind < 0. 05. In cells in which DOC produced a conductance increase of 1010 +/- 10 pS pF-1, gadolinium (0.5 mM) induced a fall in cell conductance of 1800 +/- 10 pS pF-1. In Caco2 cells, addition of DOC (0.5 mM) to the bath reversibly induced the appearance of or an increase in channel activity in patches studied in cell-attached and excised inside-out configuration. In inside-out experiments (N = 13) DOC (0. 5 mM) induced the appearance of channel activity with conductances and reversal potentials (Er) of 27.7 +/- 1.9 pS and 0.8 +/- 5.7 mV, respectively. In cell-attached patches (N = 13) these values were 24.9 +/- 4.4 pS and -18.1 +/- 6.4 mV. In excised inside-out patches from Caco2 cells, subjected to electrochemical gradients for Na+, K+ and Cl-, (+85, -85 and 0 mV, respectively), addition of DOC also induced an increase in the baseline conductance and a shift in the reversal potential from values around +25 mV to values around 0 mV. Bile salts activated both anionic and cationic channels and did not require the presence of intrace

Topics: 4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid; Amiloride; Animals; Caco-2 Cells; Calcium Channel Blockers; Cell Line; Chloride Channels; Deoxycholic Acid; Diarrhea; Humans; Ileum; Ion Channels; Membrane Potentials; ortho-Aminobenzoates; Sodium Channels; Xenopus laevis

Feline calicivirus (FCV) strains isolated from feces (E-FCV) were compared with FCV strains of respiratory origin (R-FCV). All strains were shown to be labile at pH 3.0. All strains except one strain of E-FCV were found to be sensitive to the action of trypsin. When exposed to bile salt (deoxycholic acid sodium salt), all R-FCV strains were markedly inactivated, but none of the E-FCV strains was inactivated. It was possible to select bile-resistant substrains from a bile-sensitive strain.

Topics: Animals; Antigens, Viral; Bile; Caliciviridae; Cat Diseases; Cats; Complement Fixation Tests; Deoxycholic Acid; Diarrhea; Feces; Neutralization Tests; Respiratory System; Respiratory Tract Infections

The fasting peripheral serum concentrations of cholic acid, chenodeoxycholic acid, deoxycholic acid and ursodeoxycholic acid were determined in a total of 32 patients with uraemia. Eighteen of the patients suffered from diarrhoea. A highly accurate and specific mass-fragmentographic technique with high sensitivity was used to measure the concentrations of the individual bile acids. The total amount of bile acids was normal in the two groups of patients. Patients with diarrhoea had 50% lower concentrations of deoxycholic acid than a corresponding group of healthy subjects. It is suggested that the low level of deoxycholic acid may contribute to diarrhoea in these patients.

Topics: Adult; Aged; Chenodeoxycholic Acid; Cholic Acid; Cholic Acids; Deoxycholic Acid; Diarrhea; Female; Humans; Male; Middle Aged; Peritoneal Dialysis, Continuous Ambulatory; Renal Dialysis; Uremia; Ursodeoxycholic Acid

Topics: Agar; Child; Child, Preschool; Culture Media; Deoxycholic Acid; Diarrhea; Dysentery, Bacillary; Female; Humans; Infant; Infant, Newborn; Male; Shigella; Xylose

A single-pass perfusion system was used in conscious restrained rats to measure changes in water and electrolyte transport and in protein and deoxyribonucleic acid output after perfusing 5-15-mM solutions of sulfated or nonsulfated bile acids through the colon. Perfusion with 5 mM nonsulfated deoxycholic acid or chenodeoxycholic acid changed net water and sodium absorption to net secretion, provoked marked increases in protein and DNA output into the perfusion effluent, and caused microscopic mucosal damage. In contrast, perfusion with 5 and 15 mM sulfated deoxycholic acid or with 5 mM sulfated chenodeoxycholic acid had no effect on water and electrolyte transport and caused only modest changes in protein and DNA output. To see whether or not sulfated bile acid could prevent the effect of its nonsulfated parent compound on colonic structure and function, perfusion with a mixture of 5 mM nonsulfated and 10 mM sulfated deoxycholic acid was performed. This produced net secretion of water and sodium together with less marked increases of protein and deoxyribonucleic acid output and less pronounced microscopic mucosal damage than was seen after 5 mM nonsulfated deoxycholic acid alone. Finally, 5 mM nonsulfated cholic acid had no effect on water or sodium transport, but 5 mM sulfated cholic acid, with one alpha-hydroxyl group masked and two alpha-hydroxyl groups "exposed," reduced water transport. These results suggest that sulfation prevents the cathartic effect of alpha-dihydroxyl bile acids in the colon.

Topics: Animals; Bile Acids and Salts; Biological Transport; Chenodeoxycholic Acid; Cholic Acid; Cholic Acids; Colon; Deoxycholic Acid; Diarrhea; DNA; Intestinal Mucosa; Ion Channels; Mucus; Perfusion; Proteins; Rats; Water-Electrolyte Balance

The beneficial effect of loperamide in some children with severe protracted diarrhoea which persisted when nil by mouth, made us suspect that loperamide may have an antisecretory action. Using a steady-state perfusion technique in rat jejunum we showed that loperamide inhibits cholera toxin induced secretion of water, sodium and chloride (p less than 0.001). This antisecretory action was blocked by naloxone and not mediated via an effect on tissue cyclic AMP level or adenylate cyclase activity. More recently we have studied the effect of loperamide on secretion of water in the rat jejunum induced by other agents with differing mechanisms of action. The first set of observations suggest that loperamide's antisecretory effect is mediated via opiate receptors either distal to, or separate from the adenylate cyclase/cyclic AMP pathway. Our more recent studies support the notion that loperamide has an effect on specific transport systems rather than non-specific passive diffusional processes.

Topics: Animals; Body Water; Cholera Toxin; Cyclic AMP; Deoxycholic Acid; Diarrhea; Dinoprostone; Intestinal Mucosa; Jejunum; Loperamide; Piperidines; Prostaglandins E; Rats; Rats, Inbred Strains

Topics: Bile Acids and Salts; Deoxycholic Acid; Diarrhea; Feces; Female; Humans; Lithocholic Acid; Middle Aged; Tetracycline

Topics: Adult; Aged; Celiac Disease; Deoxycholic Acid; Diarrhea; Dietary Fats; Feces; Female; Humans; Intestine, Small; Jejunum; Lipid Metabolism; Male; Micelles; Middle Aged; Ursodeoxycholic Acid

The effect of ursodeoxycholic acid ingestion on biliary bile acids and biliary lipids was studied in six patients after ileal resection. All patients had bile acid malabsorption, as documented by increased breath and fecal excretion of 14C after oral administration of [1-14C] cholylglycine. Fasting duodenal bile was collected by intubation before and seven days after ursodeoxycholic acid administration (4 g/day), and biliary bile acid and lipid composition were determined. Ursodeoxycholic acid ingestion increased the percentage of ursodeoxycholic acid in bile tenfold (3.6 +/- 2.6% vs 38.6 +/- 12.0%) and decreased chenodeoxycholic acid in bile by approximately 40%. Before ursodeoxycholic acid ingestion, bile was supersaturated in all patients. After ursodeoxycholic acid ingestion, cholesterol saturation decreased in all six patients by an average of 43%, and bile became unsaturated in five. Ursodeoxycholic acid ingestion had no effect on stool frequency. We conclude that, as in subjects with an intact enterohepatic circulation, ursodeoxycholic acid therapy has litholytic potential in patients after ileal resection.

Topics: Bile; Breath Tests; Chenodeoxycholic Acid; Cholesterol; Deoxycholic Acid; Diarrhea; Female; Humans; Ileum; Lipids; Male; Ursodeoxycholic Acid

Topics: Chenodeoxycholic Acid; Cholelithiasis; Deoxycholic Acid; Diarrhea; Female; Humans; Male; Ursodeoxycholic Acid

Topics: Animals; Bile Acids and Salts; Colon; Deoxycholic Acid; Diarrhea; Female; Indomethacin; Intestinal Mucosa; Perfusion; Prostaglandins E; Rats; Rats, Inbred Strains

Topics: Animals; Antidiarrheals; Body Water; Chlorpromazine; Deoxycholic Acid; Diarrhea; Dogs; Electrolytes; Intestinal Mucosa; Phenylurea Compounds; Propranolol; Verapamil

Topics: Chenodeoxycholic Acid; Deoxycholic Acid; Diarrhea; Humans; Transaminases; Ursodeoxycholic Acid

Topics: Animals; Biological Transport; Chenodeoxycholic Acid; Cricetinae; Deoxycholic Acid; Diarrhea; Glucose; In Vitro Techniques; Intestine, Small; Mesocricetus; Ursodeoxycholic Acid

Topics: Adenylyl Cyclases; Chenodeoxycholic Acid; Deoxycholic Acid; Diarrhea; Humans; Intestinal Mucosa; Isoproterenol; Methoxamine; Phentolamine; Propranolol; Prostaglandins E

Topics: Adult; Aged; Colon; Deoxycholic Acid; Diarrhea; Electrolytes; Female; Humans; Ileum; Intestinal Absorption; Male; Middle Aged; Water

Proximal intestinal bile acids have been studied in 14 ambulatory patients with varying degrees of azotaemia. When compared with normal subjects, the azotaemic patients showed a significant decrease in deoxycholic acid. Analysis of faecal bile acids of a patient with low intestinal deoxycholic acid also showed low deoxycholic acid with a preponderance of primary bile acids, and contrast with faecal bile acids of a normal subject and a patient with normal intestinal deoxycholic acid. It is suggested that impairment of deconjugation or 7alpha-dehydroxylation might be contributing to the low deoxycholic acid observed in azotaemic patients. Unusual bile acids: ursodeoxycholic acid, 3-hydroxy-7-keto-cholanic acid, and 3,12-dihydroxy-7-keto-cholanic acid were also noted in intestinal aspirates of azotaemic patients. The presence of these bile acids in conjunction with low deoxycholic acid correlates with the symptom of diarrhoea in azotaemic patients, and may contribute to the pathogenesis of diarrhoea in these patients.

Topics: Adolescent; Adult; Aged; Bile Acids and Salts; Deoxycholic Acid; Diarrhea; Feces; Female; Humans; Male; Middle Aged; Uremia

Four children with chronic diarrhoea and perianal excoriation after a pull-through operation for Hirschsprung's disease have been shown to have increased but not markedly raised levels of faecal bile acids. Bile acid analysis of the 'bile-rich' duodenal fluid obtained after pancreozymin stimulation in 3 of the patients indicated a marked reduction in the proportion of deoxycholic acid conjugates. These findings are compatible with colonic malabsorption of secondary bile acids in these patients which is related in some way to the pull-through operation, but which is not likely to be the cause of the diarrhoea and the anal excoriation.

Topics: Adolescent; Bile Acids and Salts; Chenodeoxycholic Acid; Child; Child, Preschool; Cholic Acids; Deoxycholic Acid; Diarrhea; Duodenum; Feces; Gastric Juice; Glycine; Humans; Lipids; Megacolon; Postoperative Complications; Taurine

Chenodeoxycholic acid is an important drug for the treatment of cholesterol cholelithiasis in man. Although no toxicity has been demostrated in man, liver lesions develop in rhesus monkeys treated with chenodeoxycholic acid. To elucidate the mechanism of toxicity, chenodeoxycholic acid. To elucidate the mechanism of toxicity, chenodeoxycholic acid was fed daily to three groups of 6 animals each at the following dose: 10, 40, and 100 mg per kg; 2 separate animals were not treated and served as controls. After 1 month, the animals were killed. During the treatment period, most blood tests (e.g., blood count, blood urea nitrogen, albumin, SGOT, lactate dehydrogenase) remained within normal limits, but there was a significant dose-related increase in serum leucine aminopeptidase levels. The percentage of lithochlic acid, the 7-dehydroxylated bacterial metabolite of chenodeoxycholic acid, rose from 1% in the control animal to almost 14% in the 100 mg per kg-treated group. Liver biopsies obtained before treatment and at necropsy showed no significant changes. Thus, exposure of the liver to increased amounts of lithocholic acid during chenodeoxycholic acid treatment might result in elevation of serum leucine aminopeptidase activity.

Topics: Animals; Bile; Body Weight; Chenodeoxycholic Acid; Cholelithiasis; Cholesterol; Cholic Acids; Deoxycholic Acid; Diarrhea; Dose-Response Relationship, Drug; Female; Leucyl Aminopeptidase; Lithocholic Acid; Liver; Macaca mulatta; Male; Phospholipids

Colonic motor activity was initiated by infusions of bile salts into the caecum or rectum of the anaesthetized rabbit. Primary bile acids were examined proximally and distally in the colon and elicited marked motor responses. Sinc dihydroxy bile acids are known to be potent inhibitors of electrolyte and water absorption in the colon, the secondary bile acid deoxycholic acid, the dihydroxyl compound most related to cholic acid which is the main bile acid in the rabbit, was examined distally and was also active, but to a lesser extent than cholic acid conjugates in this species. In man, a relationship was found between the faecal bile acid excretion and colonic motility: the introduction of bile acids directly into the human sigmoid colon and rectum also stimulated colonic motility. In man, the dihydroxy compound chenodeoxycholic acid was slightly more active than conjugates of cholic acid.

Topics: Animals; Bile Acids and Salts; Cecum; Chenodeoxycholic Acid; Cholic Acids; Colon; Deoxycholic Acid; Diarrhea; Feces; Gastrointestinal Motility; Glycocholic Acid; Humans; Neostigmine; Rabbits; Taurocholic Acid; Water-Electrolyte Balance

Topics: Bile Acids and Salts; Chenodeoxycholic Acid; Child Nutritional Physiological Phenomena; Child, Preschool; Cholic Acids; Deoxycholic Acid; Diarrhea; Diet Therapy; Dietary Proteins; Duodenum; Glycine; Glycocholic Acid; Glycols; Humans; Infant; Inhalation; Intestinal Absorption; Intestinal Mucosa; Lipid Metabolism; Lithocholic Acid; Models, Chemical; Protein-Energy Malnutrition; Taurine; Taurocholic Acid

In an experimental jejunal perfusion study, distress in healthy subjects occurred during eight out of 16 perfusions in which intestinal secretion was provoked. Calculation demonstrates the volumetric consequences of inadequate recovery of secretory perfusates, and analysis of the perfusion studies shows that distress was significantly associated with poor recovery of the perfusate. These observations are pertinent to increasing interest in the phenomenon of intestinal fluid secretion.

Topics: Carbon Radioisotopes; Chenodeoxycholic Acid; Deoxycholic Acid; Diarrhea; Glycocholic Acid; Humans; Intestinal Absorption; Intestinal Diseases; Intestinal Mucosa; Jejunum; Perfusion; Vomiting

Topics: Adult; Aged; Bile Acids and Salts; Cholic Acids; Chronic Disease; Crohn Disease; Deoxycholic Acid; Diarrhea; Feces; Female; Gastrointestinal Motility; Humans; Ileostomy; Male; Middle Aged; Postoperative Complications; Time Factors

Topics: Adult; Bile Acids and Salts; Chenodeoxycholic Acid; Cholic Acids; Chromatography, Gas; Deoxycholic Acid; Diarrhea; Drainage; Feces; Female; Humans; Lithocholic Acid; Male; Middle Aged; Vagotomy

Topics: Bile Acids and Salts; Chenodeoxycholic Acid; Cholic Acids; Chromatography, Gas; Colon; Deoxycholic Acid; Diarrhea; Feces; Humans; Lithocholic Acid; Vagotomy

Topics: Bile Acids and Salts; Chenodeoxycholic Acid; Cholic Acids; Deoxycholic Acid; Diarrhea; Feces; Humans; Lithocholic Acid; Vagotomy