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Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

Bile acid absorption was investigated using75Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch-anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole-body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P<.05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch-anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch-anal anastomosis (P<.01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy but bacterial metabolism of bile acids was greater in the pouches.

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Author notes

  1. N. S. Williams M.S., F.R.C.S.

    Present address: Surgical Unit, The London Hospital, London E1, UK

Authors and Affiliations

  1. University Department of Surgery, The General Infirmary, Leeds, UK

    D. G. Nasmyth M.S., F.R.C.S., D. Johnston M.D., F.R.C.S., N. S. Williams M.S., F.R.C.S. & R. F. G. J. King Ph.D.

  2. University Department of Medical Physics, The General Infirmary, Leeds, UK

    L. Burkinshaw Ph.D. & K. Brooks

Authors
  1. D. G. Nasmyth M.S., F.R.C.S.
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  2. D. Johnston M.D., F.R.C.S.
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  3. N. S. Williams M.S., F.R.C.S.
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  4. R. F. G. J. King Ph.D.
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  5. L. Burkinshaw Ph.D.
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  6. K. Brooks
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Additional information

Supported by a grant from the Yorkshire Regional Health Authority and was presented in part at the St. Mark's Hospital 150th Anniversary International Conference, May 29 to 31, 1985.

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Nasmyth, D.G., Johnston, D., Williams, N.S. et al. Changes in the absorption of bile acids after total colectomy in patients with an ileostomy or pouch-anal anastomosis. Dis Colon Rectum 32, 230–234 (1989). https://doi.org/10.1007/BF02554535

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  • DOI: https://doi.org/10.1007/BF02554535

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