Document Detail


Bile acid replacement therapy with cholylsarcosine for short-bowel syndrome.
MedLine Citation:
PMID:  10499484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Fat malabsorption in the short-bowel syndrome (SBS) may in part be caused by decreased bile secretion. Cholylsarcosine is a synthetic conjugated bile acid resistant to bacterial degradation with no cathartic activity. METHODS: Metabolic balance studies were performed in four patients with SBS, two with a colon and two with a jejunostomy. RESULTS: Treatment with cholylsarcosine, 6 and 12 g/day, increased fat absorption by 17 +/- 3 g/day (0.7 MJ/day; P <0.05) and 20+/-1 g/day (0.8 MJ/day; P <0.001; mean +/- standard error), respectively, to a total absorption of energy from fat of 2.0-2.2 MJ/day. Total absorption of energy increased from 11.0 MJ/day to 11.7 MJ/day (bomb calorimetry). Energy absorbed from carbohydrates (6.5 MJ/day) did not change. Faecal output increased in one of the patients with a colon and was unchanged in the other three patients. A higher percentage of the medium-chain and the unsaturated fatty acids were absorbed in comparison with the long-chain and the saturated fatty acids (100% of C8:0, 92% of C10:0, 74% of C12:0, 52% of C14:0, 30% of C16:0, 16% of C18:0, and 47% of unsaturated C18 fatty acids). Treatment with cholylsarcosine increased absorption of C14:0 by 23%-29%, of C16:0 by 59%-74%, of C18:0 by 125%-138%, and of unsaturated C18-fatty acids by 36%-45%. A fifth patient (without a colon) was enrolled in the study but had to be excluded because cholylsarcosine, 6 g/day, resulted in nausea and anorexia. CONCLUSION: Cholylsarcosine increased fat absorption in SBS. The effect was relatively more pronounced on absorption of the low-absorbable, longer-chained, and saturated fatty acids. The overall gain in absorption of energy was small (6%) because energy absorption from carbohydrates was threefold higher than that from fat. Cholylsarcosine may have cathartic effects on some SBS patients with a colon. The maximal efficacy of cholylsarcosine was reached at a dose of 6 g/day, compared with 12 g/day in three of four patients.
Authors:
S Heydorn; P B Jeppesen; P B Mortensen
Related Documents :
10485604 - Perturbed bioelectrical properties of the mouse cecum following hepatectomy and starvat...
3093054 - Gastrointestinal toxicity of chemotherapy and the influence of hyperalimentation.
17951474 - Extensive gut metabolism limits the intestinal absorption of excessive supplemental die...
8006714 - The trophic effects of long chain triglycerides on the atrophic ileal mucosa of rats.
21939584 - The effects of dietary non-starch polysaccharides on ascaridia galli infection in growe...
21628554 - Resveratrol dietary supplementation shortens the free-running circadian period and decr...
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  34     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-11-02     Completed Date:  1999-11-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  818-23     Citation Subset:  IM    
Affiliation:
Dept. of Medicine CA-2121, Rigshospitalet, University of Copenhagen, Denmark.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Calorimetry
Cholic Acids / therapeutic use*
Cross-Over Studies
Dietary Fats / analysis
Energy Intake
Energy Metabolism
Fats / analysis
Feces / chemistry
Female
Food, Formulated / analysis
Humans
Intestinal Absorption / drug effects
Male
Middle Aged
Sarcosine / analogs & derivatives*,  therapeutic use
Short Bowel Syndrome / drug therapy*,  physiopathology
Chemical
Reg. No./Substance:
0/Cholic Acids; 0/Dietary Fats; 0/Fats; 107-97-1/Sarcosine; 93790-70-6/cholylsarcosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Antipyrine, oxazepam, and indocyanine green clearance in patients with chronic pancreatitis and heal...
Next Document:  Severe liver failure in exertional heat stroke.