[The postvagotomy syndrome (author's transl)].

The postvagotomy syndrome following the operative section of the vagus nerves is characterized by diarrhoea. The incidence of diarrhoea after truneal vagotomy is about 25%, after selective vagotomy 15% and after proximal selective vagotomy only 2%. The possible pathogenetic factors are accelerated passage through the gut, disturbed bile acid metabolism, the bacterical inflammation of the small intestine, and enterohormonal dysregulation. A cholongenetic diarrhoea is probable because after vagotomy the excretion of bile acids is increased and the diarrhoea is interrupted after administring cholestyramin, which absorbs the bile salts in the intestine. In addition the pathogenetic role of an impaired function of the ileocecal valve should be discussed.