Skip to main content
Log in

Effects of dietary butter fat on fecal bile acid excretion in patients with Crohn's disease on elemental diet

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The excretion rate of fecal bile acids was determined by gas-liquid chromatography in nine patients with Crohn's disease and six healthy volunteers under two dietary conditions with different amounts of fat: during nasoduodenal tube feeding with a fat-restricted elemental diet containing approximately 1.5 g/day of fat, and during the addition of 50 g/day of butterfat by peroral administration. The fecal bile acid excretion rate on the elemental diet was significantly greater in the patients with Crohn's disease than in the healthy controls. With ingestion of the additional fat, the excretion rate was significantly increased in the patients with Crohn's disease, but not significantly changed in the healthy controls. The bile acid excretion rate in Crohn's disease correlated with fecal fat excretion, but not with either fecal weight or disease activity. These studies show that the amount of dietary fat represents an important consideration in the evaluation of bile acid malabsorption in Crohn's disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lenz K, Jensen KB, Jarnum S: Bile acid metabolism and plasma protein turnover in Crohn's disease. Scand J Gastroenterol 11:721–727, 1976

    Google Scholar 

  2. Garbutt JT, Lack L, Tyor MP: The enterohepatic circulation of bile salts in gastrointestinal disorders. Am J Med 51:627–636, 1971

    Google Scholar 

  3. Vantrappen G, Ghoos Y, Rutgeerts P, Janssen J: Bile acid studies in uncomplicated Crohn's disease. Gut 18:730–735, 1977

    Google Scholar 

  4. Mansbach CMII, Newton D, Stevens RD: Fat digestion in patients with bile acid malabsorption but minimal steatorrhea. Dig Dis Sci 25:353–362, 1980

    Google Scholar 

  5. Rutgeerts P, Ghoos Y, Vantrappen G: Bile acid studies in patients with Crohn's colitis. Gut 20:1072–1077, 1979

    Google Scholar 

  6. Rutgeerts P, Ghoos Y, Vantrappen G: Kinetics of primary bile acids in patients with nonoperated Crohn's disease. Eur J Clin Invest 12:135–143, 1982

    Google Scholar 

  7. Farivar S, Fromm H, Schindler D, McJunkin B, Schmidt FW: Tests of bile-acid and vitamin B12 metabolism in ileal Crohn's disease. Am J Clin Pathol 73:69–74, 1980

    Google Scholar 

  8. Sarva RP, Farivar S, Fromm H, Bazzoli F, Wald A, Amin PM: Comparative sensitivity of eight- and 24-hour bile acid breath tests and Schilling test in ileopathies. Am J Gastroenterol 76:432–437, 1981

    Google Scholar 

  9. Hill MJ: The effect of some factors on the fecal concentration of acid steroids, neutral steroids and urobilins. J Pathol 104:239–245, 1971

    Google Scholar 

  10. O'Morain C, Segal AW, Levi AJ: Elemental diets in treatment of acute Crohn's disease. Br Med J 281:1173–1175, 1980

    Google Scholar 

  11. Voitk AJ, Echave V, Feller JH, Brown RA, Gurd FN: Experience with elemental diet in the treatment of inflammatory bowel disease. Arch Surg 107:329–333, 1975

    Google Scholar 

  12. Goods A, Hawkins T, Feggetter JGW, Johnston IDA: Use of an elemental diet for long-term nutritional support in Crohn's disease. Lancet 1:122–124, 1976

    Google Scholar 

  13. Axelsson C, Jarnum S: Assessment of the therapeutic value of an elemental diet in chronic inflammatory bowel disease. Scand J Gastroenterol 12:89–95, 1977

    Google Scholar 

  14. Nishida T, Miwa H, Yamamoto M, Koga T, Yao T: Bile acid absorption kinetics in Crohn's disease on elemental diet after oral administration of a stable-isotope tracer with chenodeoxycholic-11,12-d2 acid. Gut 23:751–757, 1982

    Google Scholar 

  15. Best WR, Becktel JM, Singleton JW, Kern F Jr: Development of a Crohn's disease activity index. Gastroenterology 70:439–444, 1976

    Google Scholar 

  16. Van de Kamer JH, ten Bokkel Huinik H, Weyers HA: Raid method for the determination of fat in feces. J Biol Chem 177:347–355, 1949

    Google Scholar 

  17. Solomons NW, Layden TJ, Rosenberg IH, Vo-khactu K, Sandstead HH: Plasma trace metals during total parenteral alimentation. Gastroenterology 70:1022–1025, 1976

    Google Scholar 

  18. Wolman SL, Anderson GH, Marliss EB, Jeejeebhoy KN: Zinc in total parenteral nutrition: Requirements and metabolic effects. Gastroenterology 76:458–467, 1979

    Google Scholar 

  19. Nelson L, Carmichael HA, Atherton ST, Russel RI: The use of an elemental diet (Vivonex) in the management of bile acid-induced diarrhea. Gut 18:792–794, 1977

    Google Scholar 

  20. Low-Beer TS: Diet and bile acid metabolism. Clin Gastroenterol 6:165–178, 1977

    Google Scholar 

  21. Connor WE, Witiak DT, Stone DB, Armstrong ML: Cholesterol balance and fecal neutral steroid and bile acid excretion in normal men fed dietary fats of different fatty acid composition. J Clin Invest 48:1363–1375, 1969

    Google Scholar 

  22. Campbell CB, Cowley DJ, Dowling RH:Dietary factors affecting biliary lipid secretion in the rhesus monkey. A mechanism for the hypocholesterolemic action of polyunsaturated fat? Eur J Clin Invest 2:332–341, 1972

    Google Scholar 

  23. Reddy BS, Mangat S, Sheinfil A, Weisburger JH, Wynder EL: Effect of type and amount of dietary fat and 1,2-dimethylhydrazine on biliary bile acids, fecal bile acids, and neutral sterols in rats. Cancer Res 37:2131–2137, 1977

    Google Scholar 

  24. Reddy BS: Diet and excretion of bile acids. Cancer Res 41:3766–3768, 1981

    Google Scholar 

  25. Cummings JH, Wiggins HS, Jenkins DJA, Houston H, Jivraj T, Drasar BS, Hill MJ: Influence of diets high and low in animal fat on bowel habit, gastrointestinal transit time, fecal microflora, bile acid, and fat excretion. J Clin Invest 61:953–963, 1978

    Google Scholar 

  26. Melchior GW, Lofland HB, St Clair RW: The effect of polyunsaturated fats on bile acid metabolism and cholelithiasis in squirrel monkeys. Metabolism 27:1471–1484, 1978

    Google Scholar 

  27. Ammon HV, Phillips SF: Inhibition of ileal water absorption by intraluminal fatty acids. J Clin Invest 53:205–210, 1974

    Google Scholar 

  28. Crowther JS, Drasar BS, Goddard P, Hill MJ, Johson K: The effect of a chemically defined diet on the fecal flora and fecal steroid concentration. Gut 14:790–793, 1973

    Google Scholar 

  29. Mitchell WD, Eastwood MA: Fecal bile acids and neutral steroids in patients with ileal dysfunction. Scand J Gastroenterol 7:29–32, 1972

    Google Scholar 

  30. McJunkin B, Fromm H, Sarva RP, Amin P: Factors in the mechanism of diarrhea in bile acid malabsorption: Fecal pH—a key determinant. Gastroenterology 80:1454–1464, 1981

    Google Scholar 

  31. Fromm H, Thomas PJ, Hofmann AF: Sensitivity and specificity in tests of distal ileal function: Prospective comparison of bile acid and vitamin B12 absorption in ileal resection patients. Gastroenterology 64:1077–1090, 1973

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This work was supported in part by a grant from Clinical Medicine Promoting Foundation, Fukuoka City, Japan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Koga, T., Nishida, T., Miwa, H. et al. Effects of dietary butter fat on fecal bile acid excretion in patients with Crohn's disease on elemental diet. Digest Dis Sci 29, 994–999 (1984). https://doi.org/10.1007/BF01311249

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01311249

Keywords

Navigation