title: Bile acid dysfunction after clam enterocystoplasty.
abstract: OBJECTIVE
  To determine if the bowel dysfunction that develops in approximately 12% of patients after a clam enterocystoplasty is due to disruption of the enterohepatic circulation of bile acids.
  
  
  METHODS
  Fourteen symptomatic patients (mean age 36 years, range 21-65) who had undergone clam enterocystoplasty were investigated by bowel frequency charts, hydrogen breath tests of expired air and the retention of radioactive 75Se-labelled homocholic acid-taurine (SeHCAT), a synthetic bile acid. Patients with abnormal results were commenced on anion-exchange resins and the symptoms evaluated 6 weeks later.
  
  
  RESULTS
  The interruption of bile acid circulation, as estimated by SeHCAT, occurred in most of the patients studied and was due to surgical resection of the terminal ileum. All hydrogen breath tests were normal, excluding bacterial overgrowth as a cause of diarrhoea. Bowel frequency correlated well with the percentage of SeHCAT retained. Anion-exchange resins were successful in relieving the symptoms if patients complied well with the treatment.
  
  
  CONCLUSIONS
  After clam enterocystoplasty, some patients have bowel dysfunction caused by the interruption of the enterohepatic circulation of bile acids. These patients can be identified using bowel frequency charts and treated by anion-exchange resins.
authors.affiliation: Department of Urology, Cardiff Royal Infirmary, UK.
authors.forename: J W
authors.initials: JW
authors.lastname: Barrington
authors.forename: H
authors.initials: H
authors.lastname: Fern-Davies
authors.forename: R J
authors.initials: RJ
authors.lastname: Adams
authors.forename: W D
authors.initials: WD
authors.lastname: Evans
authors.forename: J P
authors.initials: JP
authors.lastname: Woodcock
authors.forename: T P
authors.initials: TP
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D000368:Aged; D001647:Bile Acids and Salts; D001944:Breath Tests; D003967:Diarrhea / Q000209:etiology*; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D007475:Ion Exchange Resins / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D001743:Urinary Bladder / Q000601:surgery*
chemical_list: D001647:Bile Acids and Salts; D007475:Ion Exchange Resins