Effect of enterocoated cholestyramine on bowel habit after ileal resection: a double blind crossover study.
Ileal resection causes malabsorption of bile acid; the increased load of bile acids in the colon induces increased secretion of salt and water and hence diarrhoea. A study was carried out to test the effect of an enterocoated cholestyramine tablet designed to disintegrate in the colon and sequester the bile acids there, thereby minimising diarrhoea induced by bile acids while having no effect on malabsorption of bile acid and jejunal fat absorption. The study comprised 14 patients who had undergone ileal resection of 40-150 cm for Crohn's disease. A double blind crossover trial was performed with placebo and cholestyramine enterocoated with cellulose acetate phthalate. During treatment with cholestyramine the daily faecal output decreased, the number of defecations each week decreased, and the intestinal transit time increased. Acceptability of the tablets was high, in contrast with general clinical experience with cholestyramine powder. No change was observed in the total faecal output of bile acids or fat. Cholestyramine tablets caused a reduction in diarrhoea without noticeably interfering with the metabolism of fat or bile acid.
D000328:Adult; D000368:Aged; D001647:Bile Acids and Salts / Q000378:metabolism; D002482:Cellulose / Q000031:analogs & derivatives; D002792:Cholestyramine Resin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003106:Colon / Q000378:metabolism; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D003967:Diarrhea / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007408:Intestinal Absorption; D008286:Malabsorption Syndromes / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013608:Tablets, Enteric-Coated
D001647:Bile Acids and Salts; D013608:Tablets, Enteric-Coated; D002792:Cholestyramine Resin; D002482:Cellulose; C011708:cellulose acetate phthalate