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Bile acid dysfunction after clam enterocystoplasty
Author(s) -
BARRINGTON J.W.,
FERNDAVIES H.,
ADAMS R.J.,
EVANS W.D.,
WOODCOCK J.P.,
STEPHENSON T.P.
Publication year - 1995
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1995.tb07667.x
Subject(s) - enterohepatic circulation , taurine , medicine , gastroenterology , ileum , bile acid , chemistry , biochemistry , amino acid
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. Patients and 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 75 Selabelled 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.