ROLE OF BILE ACIDS AND BILE ACID BINDING AGE.pdf
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ROLE OF BILE ACIDS AND BILE ACID BINDING AGE.pdf

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170Gut2000;46:170–175RoleofbileacidsandbileacidbindingagentsinpatientswithcollagenouscolitisK-AUng,RGillberg,AKilander,HAbrahamssonAbstractaetiologicalagent.18DespitethesimilarityinBackground—Inaretrospectivestudybilesymptomsbetweenbileacidmalabsorptionacidmalabsorptionwasobservedinpa-andcollagenouscolitis,fewattemptshavebeentientswithcollagenouscolitis.madetostudyapossiblerelationbetweentheAims—Tostudytheoccurrenceofbiletwoconditions.Inapreviousstudy,itwascon-acidmalabsorptionandtheeVectofbilecludedthatthereisnoevidenceofbileacidacidbindersprospectivelyinpatientswithmalabsorptioninpatientswithcollagenouschronicdiarrhoeaandcollagenouscolitis.colitis.19However,accordingtothe75Se-Methods—Over36monthsallpatientshomocholicacidtaurine(75SeHCAT)testreferredbecauseofchronicdiarrhoeaused,oneoftheeightpatientsinthatstudyhadcompletedadiagnosticprogramme,in-apparentbileacidmalabsorption,andanothercludinggastroscopywithduodenalbiopsy,patienthadaborderlinevalue.Afewpatientscolonoscopywithbiopsies,andthe75Se-havebeenreportedtorespondfavourablytohomocholicacidtaurine(75SeHCAT)testthebileacidbindingagentcholestyramine.320forbileacidmalabsorption.TreatmentInoneextensivelyinvestigatedpatientwithwithabileacidbinder(cholestyramineincollagenouscolitisthesymptomsandeventhe24,colestipolinthree)wasgiven,irrespec-histologicalchangesdisappearedwithcholesty-tiveoftheresultsofthe75SeHCATtest.raminetreatment.20TherewasnodirectorResults—Collagenouscolitiswasfoundinindirectevidenceofbileacidmalabsorptionin28patients(sixmen,22women),27ofthispatient.whomhadpersistentsymptomsandcom-Inasmallretrospectivestudyof10patients75pletedtheprogramme.FourpatientshadwithcollagenouscolitiswefoundtheSeH-hadapreviouscholecystectomyoradistalCATtesttobeabnormalinfivepatients,whogastricresection.The75SeHCATtestwassubsequentlyrespondedtotreatmentwith21abnormalin12/27(44%)ofthecollagen-cholestyramine.Theseobservationshaveouscolitispatientswith75SeHCATvaluespromptedthisfurtherstudyofther