Skip to main content

Advertisement

SpringerLink
Log in

The changes of bile acid composition in the patients with chronic pancreatitis (Including suspected chronic pancreatitis)

  • Original Article
  • Published:
Gastroenterologia Japonica Aims and scope Submit manuscript

Summary

The bile acid composition in the duodenal juice which was collected by Pancreozymin-Secretin test (P-S test) in twenty-one patients with chronic pancreatitis (including suspected chronic pancreatitis) was analyzed by gas-liquid chromatography.

Maximal bicarbonate concentration, amylase output and volume were measured as pancreatic function by P-S test. Secretory pattern of icterus index was revealed as biliary function. Relation between changes of bile acid composition, pancreatic exocrine function and secretory pattern of icterus index was examined. Results are as follows;

  1. 1)

    Secretory pattern of icterus index during P-S test showed a delayed pattern in patients with chronic pancreatitis.

  2. 2)

    Suspected chronic pancreatitis and calcifying chronic pancreatitis with normal pancreatic exocrine function showed normal bile acid composition. But, slight chronic pancreatitis and severe chronic pancreatitis showed decrease of chenodeoxycholic acid (p<0.01)and increase of secondary bile acids (deoxy cholic acid, lithocholic acid, p<0.01), respectively.

  3. 3)

    There was a negative correlation between maximal bicarbonate concentration and percentages of bile acids, such as cholic, deoxycholic and lithocholic acid.

On the other hand, it was found that there was a positive correlation between maximal bicarbonate concentration and percentage of chenodeoxycholic acid (p<0.01).

Conclusively, increase of secondary bile acids in the patients with severe chronic pancreatitis was considered to be based on the incessant contact with bacteria in the digestive canal, because of a delayed pattern of icterus index during P-S test.

Decrease of chenodeoxycholic acid was thought to be precipitated glyco-chenodeoxycholic acid which had a high dissociation constant (pKa), because of a low pH in the digestive canal resulting from insufficiency of bicarbonate excretion in the patients with chronic pancreatitis.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Imamura K, et al: Clinical features in patients with calcifying chronic pancreatitis. Jpn J Clin Exp Med 54: 147–152, 1977

    Google Scholar 

  2. Imamura K: pancreatic exocrine function in diabetic patients, Hirosaki Igaku 28 (4): 532–540, 1976

    Google Scholar 

  3. Bruton P, et al: Serum amylase and lipase levels in man after administration of secretin and pancreozymin. Gut 1: 125–128, 1960

    Article  Google Scholar 

  4. Go VLW, et al: Disturvances insfat digestion induced by acidic jejunal pH due to gastric hypersecretion in man 58: 638–646, 1970

    CAS  Google Scholar 

  5. Borgstroem B, et al: Studies of intestinal digestion and absorbtion in the human. J Clin Invest 36: 1521–1536, 1957

    Google Scholar 

  6. Carey MC, Small PM: Micelle formation by bile salts, physicalchemical and thermodynamic conditions. Arch Intern Med 130: 506–549, 1972

    Article  PubMed  CAS  Google Scholar 

  7. Fields M, Duthie HL: Effect of vagotomy on intraluminal digestion of fat in man. Gut 6: 301–310, 1965

    Article  CAS  PubMed  Google Scholar 

  8. Hofman AF: The function of bile salts in fat digestion. JBiochem 89: 57–68 1963

    Google Scholar 

  9. Roller RJ, Kern F: Minimal bile acid malabsorption and normal bile acid breath tests in cystic fibrosis and aquired pancreatic insufficiency. Gastroenterology 72: 661–665, 1977

    PubMed  CAS  Google Scholar 

  10. Caraway WT: A stable starch sbstrate for the determination of bile acids in bile. Clin Chim Acta 35: 225–229, 1971

    Article  Google Scholar 

  11. Miyazaki H, et al: Simultaneous qualitative and qualitative analysis of bile acids by mass chromatography. J Chromatgr 99: 553–565, 1974

    Article  CAS  Google Scholar 

  12. Nakamura T, et al: The changes of bile acid composition in the duodenal fluid of patients with chronic pancreatitis. Igakuno ayumi 105 (6): 611–612, 1978

    CAS  Google Scholar 

  13. Hansson K: Experimental and clinical studies in etiologic role of bile reflux in acute pancreatitis. Acta Chir Scand Supp: 375, 1976

  14. Schmidt H, Creutzfelt W: The possible role of phospholipase A in the pathogenesis of acute pancreatitis. Scand J Gastroent 4: 39–48, 1969

    Article  PubMed  CAS  Google Scholar 

  15. Pomare E, Heaton KW: Unpublished studies (1971) Bile salts in Health and Disease, ed. by Heaton, K.W. Churchill Livingstone, Edinburgh and London, 1972

    Google Scholar 

  16. Weber AM, et al: Malabsorption of bile acids in children with cystic fibrosis. N Engl J Med 289: 1001–1005, 1973

    Article  PubMed  CAS  Google Scholar 

  17. Beher WT: Bile acids, chemistry and physiology of bile acids and their influence on atherosclerosis, S. Karger. Basel, Muenchen, Paris, London, New York, Sydney, 1976, pp 17–47

Download references

Author information

Authors and Affiliations

  1. 3rd Department of Internal Medicine, Hirosaki University School of Medicine, Zaifu-cho, 5, 036, Hirosaki City, Japan

    Teruo Nakamura M.D.

Authors
  1. Teruo Nakamura M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakamura, T. The changes of bile acid composition in the patients with chronic pancreatitis (Including suspected chronic pancreatitis). Gastroenterol Jpn 14, 114–121 (1979). https://doi.org/10.1007/BF02773582

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02773582

Key Words

Search

Navigation