Document Detail

Biliary sphincterotomy does not relate to diarrhoea or major changes in bile acid synthesis or plasma lipids.
MedLine Citation:
PMID:  19811340     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Bile acid (BA) malabsorption may occur after cholecystectomy. Bile may flow more freely into the duodenum after endoscopic sphincterotomy (EST), in part resembling the situation after cholecystectomy. The (75)SeCHAT test used to diagnose BA malabsorption correlates inversely with synthesis and faecal excretion of BAs. The BA intermediate 7alpha-hydroxy-4-cholesten-3-one (C4) mirrors BA and lathosterol cholesterol synthesis. The aim was to study whether EST causes BA diarrhoea and alterations in BA synthesis or lipid profiles.
MATERIAL AND METHODS: Twelve patients underwent the (75)SeHCAT test prior to and 3 months after undergoing EST and a further 22 only after EST. The Gastrointestinal Symptom Rating Scale (GSRS), 1 week daily stool frequency and consistency, C4, lathosterol, cholesterol and triglycerides were investigated. The (75)SeHCAT values of 29 healthy subjects served as controls.
RESULTS: Stool frequency (median 1/day, IQR (interquartile range): 0.7) and consistency (median: 3, IQR: 0.65) were normal and none reported diarrhoea after EST (n=34). The GSRS scores were normal. There was no significant change in (75)SeHCAT (median 22%, IQR 29% versus 19.5%, IQR 25, n=12). There was a trend towards lower (75)SeHCAT after EST compared with the controls (median 26%, IQR 32, n=34 versus median 38%, IQR 19.5, n=29, p=0.075) and higher lathosterol (median 47.1 mg/mole, IQR 32.7 versus median 52.5 mg/mole, IQR 35.6, n=14, p=0.055). The C4 and lipids did not change significantly.
CONCLUSIONS: EST did not induce diarrhoea and in line with this BA synthesis and serum lipids are unaltered.
Kjell-Arne Ung; Nima Mottacki; Mats Rudling; Antal Bajor
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  44     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2009  
Date Detail:
Created Date:  2009-10-08     Completed Date:  2010-02-26     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1132-8     Citation Subset:  IM    
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MeSH Terms
Bile Acids and Salts / biosynthesis*
Case-Control Studies
Cholestenones / diagnostic use
Diarrhea / etiology*
Feces / chemistry
Lipids / blood*
Middle Aged
Selenium Radioisotopes / diagnostic use
Sphincterotomy, Endoscopic*
Statistics, Nonparametric
Taurocholic Acid / analogs & derivatives,  diagnostic use
Reg. No./Substance:
0/Bile Acids and Salts; 0/Cholestenones; 0/Lipids; 0/Selenium Radioisotopes; 3862-25-7/7 alpha-hydroxy-4-cholesten-3-one; 5E090O0G3Z/Taurocholic Acid; 75018-70-1/23-seleno-25-homotaurocholic acid

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

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