Document Detail

Prolonged large bowel transit increases serum deoxycholic acid: a risk factor for octreotide induced gallstones.
MedLine Citation:
PMID:  10205204     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Treatment of acromegaly with octreotide increases the proportion of deoxycholic acid in, and the cholesterol saturation of, bile and induces the formation of gallstones. Prolongation of intestinal transit has been proposed as the mechanism for the increase in the proportion of deoxycholic acid in bile. AIMS: To study the effects of octreotide on intestinal transit in acromegalic patients during octreotide treatment, and to examine the relation between intestinal transit and bile acid composition in fasting serum. METHODS: Mouth to caecum and large bowel transit times, and the proportion of deoxycholic acid in fasting serum were measured in non-acromegalic controls, acromegalic patients untreated with octreotide, acromegalics on long term octreotide, and patients with simple constipation. Intestinal transit and the proportion of deoxycholic acid were compared in acromegalic patients before and during octreotide. RESULTS: Acromegalics untreated with octreotide had longer mouth to caecum and large bowel transit times than controls. Intestinal transit was further prolonged by chronic octreotide treatment. There were significant linear relations between large bowel transit time and the proportion of deoxycholic acid in the total, conjugated, and unconjugated fractions of fasting serum. CONCLUSIONS: These data support the hypothesis that, by prolonging large bowel transit, octreotide increases the proportion of deoxycholic acid in fasting serum (and, by implication, in bile) and thereby the risk of gallstone formation.
M J Veysey; L A Thomas; A I Mallet; P J Jenkins; G M Besser; J A Wass; G M Murphy; R H Dowling
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  44     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-10     Completed Date:  1999-06-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  675-81     Citation Subset:  AIM; IM    
Gastroenterology Unit, 5th floor, Thomas Guy House, Guy's Hospital, London SE1 9RT, UK.
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MeSH Terms
Acromegaly / blood,  drug therapy*,  physiopathology
Bile Acids and Salts / blood
Cholelithiasis / chemically induced
Deoxycholic Acid / blood*
Drug Administration Schedule
Fasting / physiology
Gastrointestinal Agents / pharmacology*,  therapeutic use
Gastrointestinal Transit / drug effects*
Intestine, Large / physiopathology
Middle Aged
Octreotide / pharmacology*,  therapeutic use
Risk Factors
Reg. No./Substance:
0/Bile Acids and Salts; 0/Gastrointestinal Agents; 83-44-3/Deoxycholic Acid; 83150-76-9/Octreotide

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

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