Bile acid metabolism after jejunoileal bypass operation for obesity
Bruusgaard, A.; Sörensen, T.I.; Justesen, T.; Krag, E.
Scandinavian Journal of Gastroenterology 11(8): 833-838
1976
ISSN/ISBN: 0036-5521 PMID: 1006159 Document Number: 106975
Bile acid metabolism and duodenal bacterial flora were studied in 12 obese patients before and 1 to 2 months after jejunoileal bypass operation, including 37.5 cm jejunum and 12.5 cm ileum (Type I) or 12.5 cm jejunum and 37.5 cm ileum (Type III). The cholic acid pool size was unchanged after type I, but decreased after type III bypass. The daily fractional turnover of cholic acid increased about 5 times after both types of operation. The synthesis rate of cholic acid increased after both types of bypass, but more after type I. In duodenal bile the ratios of cholic to deoxycholic acid and of glycine to taurine conjugates increased after type I, but were unchanged after type III bypass, whereas the ratio of cholic to chenodeoxycholic acid was unchanged after both types. The bacterial flora and the occurrence of free bile acids in the fasting duodenal contents did not change after either bypass operation. It is concluded that jejunoileal bypass results in disturbances in bile acid metabolism; these are most severe after bypass including the longest ileum, possibly because of insufficient stimulation of bile acid synthesis in that type of operation.