Williams C N, Dickson R C
Can Med Assoc J. 1972 Oct 7;107(7):626-31.
The pathophysiology of cholerrheic enteropathy is described and a series of patients reviewed. Of 11 patients with chronic disabling diarrhea and steatorrhea after ileal resection or bypass, two had recurrent ileitis, three had lactose intolerance and six of those operated on five years or more previously had vitamin B(12) deficiency. Cholestyramine was given alone or with medium-chain triglyceride (MCT) or Portagen (MCT and lactose). The maximal response occurred when cholestyramine was given with Portagen - significantly reduced stool frequency and weight in all patients and stool fat in five. Restudy of five patients four to 11 months later showed the same pattern of response: cholestyramine with 70% MCT abolished symptoms in four patients (ileectomy) and 100% MCT alone greatly improved the condition of the fifth (extensive small bowel resection).
本文描述了胆汁性腹泻性肠病的病理生理学，并回顾了一系列患者。在11例回肠切除或旁路术后出现慢性致残性腹泻和脂肪泻的患者中，2例患有复发性回肠炎，3例乳糖不耐受，6例在5年或更早之前接受手术的患者存在维生素B12缺乏。单独给予消胆胺或与中链甘油三酯（MCT）或Portagen（MCT和乳糖）联合使用。当消胆胺与Portagen联合使用时出现最大反应——所有患者的大便频率和重量显著降低，5例患者的粪便脂肪减少。4至11个月后对5例患者的再次研究显示出相同的反应模式：消胆胺与70% MCT联合使用使4例患者（回肠切除术）症状消失，单独使用100% MCT使第5例患者（广泛小肠切除术）的病情大为改善。
