Microbial flora and bile acid metabolism in patients with an ileal reservoir.
Bacterial flora of ileum effluent and bile acid metabolism were investigated in 11 patients 11-44 months after construction of a Kock's continent ileostomy. Bacteriologic investigation showed significantly more microorganisms per millilitre (p less than 0.01) and a more colon-like flora--that is, anaerobic microorganisms (p less than 0.001)--in ileum effluent of continent ileostomy patients than in ileum effluent of patients with a conventional ileostomy. The reabsorptive capacity of the reservoir mucosa was tested by direct introduction of a radioactively labelled conjugated bile acid, 23-75Se-25-homotaurocholic acid (SeHCAT), into the ileal pouch. After 4 h, 90% of the SeHCAT activity had been reabsorbed from the reservoir. Quantitative and differential analysis of bile acids in the ileum effluent showed unconjugated and predominantly primary (88%) bile acids, suggesting a minimal influence of bacterial flora on bile acid metabolism. Moreover, total bile acid loss appeared to be within normal limits.
Go
P M
PM
Dept. of Surgery, De Wever Hospital, Heerlen, The Netherlands.
van Dieijen-Visser
M P
MP
Davies
B I
BI
Lens
J
J
Brombacher
P J
PJ
D000328:Adult; D001647:Bile Acids and Salts / Q000378:metabolism*; D006801:Humans; D007081:Ileostomy; D007082:Ileum / Q000382:microbiology*; D007408:Intestinal Absorption; D007419:Intestinal Secretions / Q000382:microbiology; D008875:Middle Aged
D001647:Bile Acids and Salts