Bile acid metabolism in patients with non-strangulated intestinal obstruction.

The intraluminal changes of bile acids were studied in 42 patients with intestinal obstruction, treated from 1978-1982. Twenty-two patients received surgical treatment and twenty were treated conservatively. Bile acid analysis of the intestinal contents was performed by thin-layer and gas-liquid chromatography. A marked reduction of bile acid concentration was observed before treatment. A decreased percentage of deoxycholic acid, a lowered G : T ratio, and presence of deconjugated bile acids were also present. After relief and/or removal of the obstruction, the concentration of bile acids, the percentage of deoxycholic acid, and the G : T ratio increased. Bile acid deconjugation decreased immediately after surgical treatment but was not affected by conservative treatment. We conclude that bile acid metabolism is altered quantitatively and qualitatively in patients with an intestinal obstruction.