Abstract
Fecal bile acids were measured by gas chromatography in 39 ambulatory children (age 3 mos.-4 yrs.) with chronic diarrhea of 2-18 mos. duration. Ten normals (age 2 mos.-4 yrs.) were controls. Clinical response to cholestyramine or Pepto Bismol was compared in those with brown or green diarrheal stools. Within each category, bile acid levels were unrelated to age, sex, diet or etiology. The normals' mean excretion was 1.43 mg/gm dry wgt. (.35-3.4). Those with green stools had a mean of 8.16 mg/gm (1.63-29.05), and those with yellow or brown stools had a mean of 3.72 mg/gm (.6-10.48). Bile acids in green stools were significantly elevated above normals (p .01) and brown stools (p .025). Thirteen of 15 responded to Pepto Bismol or cholesty-ramine and more than doubled fecal excretion, but 0 of 8 with brown stools responded. Treatment required an average of 4 wks. (3 days-3 mos.). B12 absorption was abnormal in 2 of 3 with green stools and 0 of 2 with brown stools. This study suggests that abnormal bile acid metabolism is present in chronic, watery, green diarrhea, and bile acid binding agents (cholestyramine and Pepto Bismol) are indicated for treatment. We speculate that ileal dysfunction plays a pathogenetic role in this condition.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kocoshis, S., Ghent, C., Bloomer, J. et al. 447 FECAL BILE ACIDS IN GREEN DIARRHEA. Pediatr Res 12 (Suppl 4), 438 (1978). https://doi.org/10.1203/00006450-197804001-00452
Issue Date:
DOI: https://doi.org/10.1203/00006450-197804001-00452