Scarpello J H, Sladen G E
Gut. 1977 Sep;18(9):736-41. doi: 10.1136/gut.18.9.736.
The (14)C-glycocholic acid test ((14)C-GCA) has been assessed in 27 patients who have had resection of the ileum and colon for Crohn's disease and in 19 patients with unoperated stable Crohn's disease. The incidence of increased breath output of (14)CO(2) and faecal output of (14)C was significantly greater in operated patients. Half the unoperated patients had normal results and, of the others, a modest increase in faecal (14)C was the usual finding. There was no correlation between the (14)C-GCA test, the Schilling test, and the extent and severity of the radiological signs in the unoperated patients. Metronidazole therapy was poorly tolerated and had little or no influence on symptoms but did decrease the excretion of (14)CO(2) in the breath when the (14)C-GCA test was repeated. Cholestyramine therapy was beneficial in the majority of resected patients with diarrhoea and an increased faecal (14)C excretion and, on repeat testing, there was a significant increase in the output of breath (14)CO(2). The beneficial effect was less marked in the unoperated patients and the breath (14)CO(2) output remained normal in those retested. Interruption of the enterohepatic circulation of bile acids did not seem to make an important contribution to the symptoms of patients with stable unoperated (and uncomplicated) Crohn's disease, even when the ileum was extensively involved.
对27例因克罗恩病行回肠和结肠切除术的患者以及19例未经手术治疗的稳定期克罗恩病患者进行了¹⁴C-甘氨胆酸试验（¹⁴C-GCA）。手术患者呼出¹⁴CO₂量增加和粪便¹⁴C排出量增加的发生率明显更高。未手术患者中有一半结果正常，其余患者中，粪便¹⁴C适度增加是常见表现。在未手术患者中，¹⁴C-GCA试验、希林试验与放射学征象的范围和严重程度之间无相关性。甲硝唑治疗耐受性差，对症状影响很小或没有影响，但在重复¹⁴C-GCA试验时确实减少了呼出的¹⁴CO₂量。消胆胺治疗对大多数有腹泻且粪便¹⁴C排泄增加的切除术后患者有益，再次检测时，呼出的¹⁴CO₂量显著增加。在未手术患者中，有益效果不明显，再次检测的患者呼出的¹⁴CO₂量仍正常。胆汁酸肠肝循环的中断似乎对未经手术治疗（且无并发症）的稳定期克罗恩病患者的症状没有重要影响，即使回肠广泛受累。
