Abstract
The effect of calcium carbonate (6 g daily) and of aluminum hydroxide (Amphojel, 7.2 g daily) on human gastrointestinal function was examined because these popular antacids have a documented effect on fecal fat, an undocumented association with constipation, and a putative ability to ameliorate cocarcinogenic effects of bile acids and fatty acids on colonic mucosa. Intake-output studies were conducted over periods of three weeks during which time dietary intake was controlled (20 g fiber daily), and the order of treatment (control, calcium carbonate, aluminum hydroxide) was randomized. Neither calcium carbonate nor aluminum hydroxide altered the mean intestinal transit time of eight subjects. Calcium carbonate increased daily output of feces from 106±30 (SD) to 131 ±41 g, of fecal fatty acids from 7.9±1.4 to 16.8±15.4 mmol, and of fecal 3α-hydroxy-bile acids from 411±223 to 769±505 μmol. Aluminum hydroxide increased daily output of feces to 143±43 g, of fecal fatty acids to 12.4 ±5 mmol, and of fecal bile acids to 735 ±592 μmol. Both Ca2+ and Al3 precipitated deoxycholate when these ions were incubated in vitro. These observations help to explain how these two antacids may lower blood lipids and ameliorate the effects of fecal bile acids and fatty acids on colonic mucosa.
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Drenick EJ: The influence of ingestion of calcium and other soap-forming substances on fecal fat. Gastroenterology 41:242–244, 1961
Yacowitz H, Fleishman AI, Bierenbaum ML: Effects of oral calcium on serum lipids in man. Br Med J 1:1353–1354, 1965
Wargovich MJ, Eng VWS, Newmark HL, Bruce WR: Calcium ameliorates the toxic effect of deoxycholic acid on colonic epithelium. Carcinogenesis 4:1205–1207, 1983
Newmark HL, Wargovich MJ, Bruce WR: Colon cancer and dietary fat, phosphate and calcium: A hypothesis. J Natl Cancer Inst 72:1323–1325, 1984
Lipkin M, Newmark H: Effect of added dietary calcium on colonic epithelial-cell proliferation in subjects at high risk for familial colonic cancer. N Engl J Med 313:1381–1384, 1985
Clemens JD, Feinstein AR: Calcium carbonate and constipation: A historical review of medical mythopoeia. Gastroenterology 72:957–961, 1977
Evrard E, Janssen G: Gas-liquid chromatographic determination of human fecal bile acids. J Lipid Res 9:226–236, 1968
Beher WT, Stradnieks S, Lin GJ: Rapid photometric determination of free and esterified 3-hydroxy fecal bile acids. Steroids 41:729–740, 1983
Cummings JH, Jenkins DJA, Wiggiris HS: Measurement of the mean transit time of dietary residue through the human gut. Gut 17:210–218, 1976
Addison JF, Foulks CJ: Calcium carbonate: An effective phosphorus binder in patients with chronic renal failure. Curr Ther Res 38:241–249, 1985
Samuel P, Saypol GM, Meilman E, Mosbach EH, Chafizadeh M: Absorption of deoxycholate by the human colon. J Clin Invest 47:2070–2078, 1968
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Saunders, D., Sillery, J. & Chapman, R. Effect of calcium carbonate and aluminum hydroxide on human intestinal function. Digest Dis Sci 33, 409–413 (1988). https://doi.org/10.1007/BF01536023
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DOI: https://doi.org/10.1007/BF01536023