| Bile acid replacement therapy with cholylsarcosine for short-bowel syndrome. | |
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MedLine Citation:
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PMID: 10499484 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S Heydorn; P B Jeppesen; P B Mortensen |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Scandinavian journal of gastroenterology Volume: 34 ISSN: 0036-5521 ISO Abbreviation: Scand. J. Gastroenterol. Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-11-02 Completed Date: 1999-11-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0060105 Medline TA: Scand J Gastroenterol Country: NORWAY |
Other Details:
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Languages: eng Pagination: 818-23 Citation Subset: IM |
Affiliation:
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Dept. of Medicine CA-2121, Rigshospitalet, University of Copenhagen, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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
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