Abstract
Bile acid (BA) losses in CF are comparable to those seen in ileal resections and are decreased by pancreatic enzymes (Weber et al, N.Eng.J.Med. 289: 1001, 1973). Pool size (1.02 and .94g) was measured in 2 CF children off pancreatic enzymes by the technique of isotope dilution. Fasting intra-duodenal BA concentrations (25.1 and 22.0mM) were normal. However, the % of deoxycholic acid (10.8 and 8.5) was less than 1/2 reported values and the ratio of glycine/taurine conjugates (4.7 and 4.4) was high. The fecal excretion of BA (.69 and .72g) represented a daily loss of 70% and 77% of their respective pool. The decreased % of secondary BA in their stools reinforced the findings in bile. It was similar to that found in 5 cases of ileal resection (44.2±5.3) as well as in 5 other untreated CF children (46.6±4.5). When the latter were restudied on pancreatic enzymes, the proportion of secondary BA increased significantly (P<.001) but was still lower than in 5 controls (87±6.7) and in 5 celiac patients (87.6±3.6). These data indicate that the increased fecal excretion in CF is secondary to BA malabsorption and not to an enlarged pool. Qualitative fecal BA patterns, because of their similarity with those of patients with ileal resections and their response to pancreatic supplements, suggest either a specific ileal absorptive defect or an unidentified intraluminal factor.
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Roy, C., Weber, A., Chartrand, L. et al. BILE ACID KINETICS AND FECAL PATTERNS IN CYSTIC FIBROSIS. Pediatr Res 8, 385 (1974). https://doi.org/10.1203/00006450-197404000-00272
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DOI: https://doi.org/10.1203/00006450-197404000-00272