Papers And Originals

Intraluminal Precipitation of Bile Acids in Stagnant Loop Syndrome

Br Med J 1973; 2 doi: https://doi.org/10.1136/bmj.2.5869.743 (Published 30 June 1973) Cite this as: Br Med J 1973;2:743
  1. T. C. Northfield

    Abstract

    The postprandial concentrations of free and conjugated bile acids were measured in total content and micellar phase of jejunal aspirates from nine patients with steatorrhoea due to the stagnant loop syndrome and from 11 normal controls. Aspirates from the stagnant loop syndrome patients, but not from the normal controls, had a high concentration of free (unconjugated) bile acids. There was a reciprocal decrease in the concentration of conjugated bile acids, but total bile acid concentration in the whole aspirate remained normal. Total bile acid concentration in the micellar phase of intestinal content was reduced, indicating precipitation of bile acids. These findings suggest that precipitation of unconjugated bile acids, rather than passive absorption, leads to a reduced postprandial concentration of bile acids in the micellar phase of jejunal content, and are consistent with the hypothesis that fat malabsorption in the stagnant loop syndrome results from decreased micellar dispersion of lipolytic products.