oxalates and Biliary-Tract-Diseases

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

Because of their amphiphilic properties, bile acids have important physiological functions. However, they can also be pathogenetically active. Some recent findings on the biochemistry and enterohepatic circulation of bile acids are presented. In contrast to the adult liver where the only primary bile acids formed are cholic- and chenodeoxycholic acid, the foetal liver is able to synthesise a variety of "atypical" bile acids. Under certain circumstances, a retrograde differentiation is possible in the adult. The very effective transport systems in gut and in the sinusoidal and canalicular membrane of the liver cell limit the bile acids almost exclusively to the enterohepatic circulation. During transport in blood, through biomembranes and in the liver cytosol, bile acids are bound to carrier proteins. The carrier has been detected using photoaffinity labelling. Following biotransformation (sulphation and glucuronidation) pathogenetically active bile acids can be converted into derivatives which can be rapidly eliminated. Disturbances of these mechanisms result in functional defects and diseases. The pathological significance of bile acids in hepato-biliary diseases is represented with regard to the cholestatic and proliferative effect of individual bile acids. The significance of bile acids in chologenic diarrhea, steatorrhea and enteral hyperoxaluria are presented as examples of the pathogenetic effects of bile acids on the gut. In these diseases it is possible to recognise the specific effects of certain bile acids on the colon mucosa. Recent studies have demonstrated that bile acids are possibly of pathogenetic significance in the case of epidemiologically proven relationship between colon carcinoma and high fat, high cholesterol and low fibre diets.

Topics: Bile Acids and Salts; Biliary Tract Diseases; Biological Transport, Active; Carrier Proteins; Celiac Disease; Cholestasis; Colonic Neoplasms; Cytosol; Diarrhea; Humans; Intestinal Absorption; Kidney Calculi; Lipoproteins, HDL; Liver; Liver Diseases; Molecular Weight; Oxalates

Bile acids and their metabolism play an important role in the pathogenesis of many gastro-intestinal diseases such as gallstone formation, biliary fistula, intestinal congestive symptoms, defective function of the terminal ileum, ulcer pathogenesis. The diagnostics has been improved by enzymatic estimation methods of the bile acids in the serum, functional tests and radioactive marking of the bile acids. Principles of causal surgical therapy as well as internal treatment can be derived from this new pathophysiological knowledge.

Topics: Bile Acids and Salts; Biliary Tract Diseases; Humans; Ileum; Intestinal Diseases; Liver Diseases; Oxalates; Peptic Ulcer; Postoperative Complications; Vagotomy

Topics: Bacteria; Bile Acids and Salts; Biliary Tract Diseases; Celiac Disease; Cholelithiasis; Cholestyramine Resin; Colon; Diarrhea; Diet; Enterohepatic Circulation; Fecal Impaction; Gastrointestinal Motility; Humans; Hydrogen-Ion Concentration; Ileum; Intestinal Absorption; Intestines; Neomycin; Oxalates; Triglycerides; Water-Electrolyte Balance

The excretion of urinary acidic metabolites by 10 patients undergoing gastric or biliary tract surgery has been studied. Five patients were infused with xylitol and 5 with glucose. Four of the xylitol-infused patients had hyperglycollic aciduria and 3 of the glucose-infused patients had hyperlactic aciduria. There was no hyperoxaluria. Four of the xylitol-infused patients excreted more tetronic acids than any of the glucose-infused patients. Threonic acid was the predominant tetronic acid excreted by most (4/5) of the xylitol-infused subjects. Erythronic acid predominated in the glucose-infused as in control ambulant non-hospitalised subjects. It is suggested that these changes point to overloading of the transketolase pathway during xylitol infusion.

Topics: Biliary Tract Diseases; Carboxylic Acids; Furans; Glucose; Glycolates; Humans; Hydroxybutyrates; Lactates; Oxalates; Parenteral Nutrition; Postoperative Care; Stomach Diseases; Sugar Acids; Transketolase; Xylitol