MILD BILE ACID MALABSORPTION AND NORMAL EXCRETION OF FECAL HYDROXY FATTY ACIDS IN PATIENTS WITH CHRONIC PANCREATITIS

Abstract

The conjugated bile acid composition was investigated in duodenal juice of eleven patients with chronic pancreatitis, and the bile acid composition and hydroxy fatty acid concentration was also analized in feces of nine patients with chronic pancreatitis in a gas chromatograph.
The results showed a markedly reduced proportion of glyco-CDCA in the duodenal juice of the patients wish chronic pancreatitis as compared with the healthy controls. Among the pancreatic exocrine functions by pancreozymine-secretin test, there was a significant correlation between maximal bicarbonate concentration and the proportion of glyco-CDCA. The mean of glycine-to taurine-conjugated bile acid ratio (G/T ratio) in duodenal juice was 2.91±0.4 in the patients and 1.91±0.7 in the controls.
The amount of fecal bile acids excretion was significantly greater in the patients than in the control subjects. This abnormality was mainly due to significant increase in fecal excretion of CDCA in the patients when compared with the controls.
The amount of fecal excretion of total fatty acids was also observed to be significantly increased in the patients, but there was no significant difference in the proportion of hydroxy-fatty acid in both groups. These studies suggest that there is a mild bile acid malabsorption in patients with chronic pancreatitis. However, no obvious evidences which suggest bacterial overgrowth in the intestine were derived from the measurement of fecal hydroxy-fatty acid.