Department of Medicine V, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
Eur J Intern Med. 2011 Dec;22(6):e137-40. doi: 10.1016/j.ejim.2011.08.013. Epub 2011 Sep 9.
The liver produces and secretes bile acids into the small intestine. In the small intestine, most of the bile acids are absorbed in the distal ileum with portal vein transportation back to the liver and resecretion (enterohepatic recycling). Increased spillover of bile acids from the small intestine into the colon (bile acid malabsorption) may affect the secretion of colonic water and electrolytes and result in watery diarrhoea. The aim of this study was to investigate the frequency of bile acid malabsorption and treatment responses to cholestyramine with (75)SeHCAT scanning among patients suffering from chronic watery diarrhoea.
This was a retrospective study that included all patients who received a (75)SeHCAT scan over a five-year period (2004-2009).
In total, 298 patients (198 females, 100 men) with a median age of 42 years (range 16-82 years) were investigated. Bile acid malabsorption ((75)SeHCAT retention<15% after seven days) was identified in 201 patients (68%, 95% confidence interval (CI): 62%-73%). Bile acid malabsorption due to ileal dysfunction (Type I) was found in 77 patients, idiopathic bile acid malabsorption (Type II) was found in 68 patients and 56 patients with other conditions had bile acid malabsorption (Type III). Of the 150 patients who were able to take cholestyramine continuously, 108 patients (71%, CI: 63%-78%) reported a positive effect on their bowel habits.
Bile acid malabsorption is a frequent problem in patients with chronic watery diarrhoea. Treatment with bile acid binders was effective regardless of type and severity.
肝脏将胆汁酸分泌到小肠中。在小肠中，大部分胆汁酸在回肠远端被吸收，通过门静脉运输回到肝脏并重新分泌（肠肝循环）。胆汁酸从小肠溢出到结肠（胆汁酸吸收不良）增加，可能会影响结肠水和电解质的分泌，导致水样腹泻。本研究旨在调查患有慢性水样腹泻的患者中胆汁酸吸收不良的频率以及用（75）SeHCAT 扫描检测到的考来烯胺治疗反应。
这是一项回顾性研究，包括在五年期间（2004-2009 年）接受（75）SeHCAT 扫描的所有患者。
共有 298 名患者（198 名女性，100 名男性），中位年龄为 42 岁（范围 16-82 岁）。201 名患者（68%，95%置信区间（CI）：62%-73%）存在胆汁酸吸收不良（7 天后（75）SeHCAT 保留率<15%）。77 名患者存在回肠功能障碍引起的胆汁酸吸收不良（I 型），68 名患者存在特发性胆汁酸吸收不良（II 型），56 名患者存在其他疾病引起的胆汁酸吸收不良（III 型）。在 150 名能够连续服用考来烯胺的患者中，108 名患者（71%，CI：63%-78%）报告其肠道习惯有改善。
胆汁酸吸收不良是慢性水样腹泻患者常见的问题。无论类型和严重程度如何，使用胆汁酸结合剂治疗都有效。
