Value of small intestinal bile acid analysis in the diagnosis of the stagnant loop syndrome. 1973

T C Northfield, and B S Drasar, and J T Wright

We have studied simple methods of analysing bile acids in human small intestinal aspirates, in order to assess their suitability for the routine clinical investigation of patients with steatorrhoea. Following extraction into methanol, samples were analysed qualitatively for bile acid deconjugation by thin-layer chromatography and quantitatively by the 3-alpha-hydroxysteroid dehydrogenase enzyme assay. These methods were found to give good recoveries, and to be sensitive, accurate, and specific, in addition to being sufficiently simple and rapid for routine diagnostic purposes. This diagnostic procedure was applied to the identification of patients with steatorrhoea due to the stagnant loop syndrome, and was compared with other tests for this condition, viz, study of the small intestinal bacterial flora, urinary indican excretion, and the Schilling test with added intrinsic factor. Three groups of subjects were studied; group I consisted of nine patients with steatorrhoea due to the stagnant loop syndrome; group II (disease control group) of six patients with an anatomical stagnant loop that was not causing steatorrhoea; and group III (normal control group) of 11 subjects with no known gastrointestinal disease. The screening of postprandial upper jejunal samples for bile acid deconjugation proved the most useful diagnostic test, being positive in eight out of nine patients from group I, but in none of those from groups II and III. At lower levels of the small intestine, bile acid deconjugation was found in subjects from groups II and III. The other three diagnostic tests discriminated poorly between subjects from group I and those from group II.

UI MeSH Term Description Entries
D007408 Intestinal Absorption Uptake of substances through the lining of the INTESTINES. Absorption, Intestinal
D007421 Intestine, Small The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM. Small Intestine,Intestines, Small,Small Intestines
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001765 Blind Loop Syndrome A malabsorption syndrome that is associated with a blind loop in the upper SMALL INTESTINE that is characterized by the lack of peristaltic movement, stasis of INTESTINAL CONTENTS, and the overgrowth of BACTERIA. Such bacterial overgrowth interferes with BILE SALTS action, FATTY ACIDS processing, MICROVILLI integrity, and the ABSORPTION of nutrients such as VITAMIN B12 and FOLIC ACID. Bacterial Overgrowth Syndrome,Stagnant Loop Syndrome,Loop Syndrome, Stagnant,Loop Syndromes, Stagnant,Stagnant Loop Syndromes,Syndrome, Bacterial Overgrowth,Syndrome, Blind Loop,Syndrome, Stagnant Loop,Syndromes, Stagnant Loop
D002446 Celiac Disease A malabsorption syndrome that is precipitated by the ingestion of foods containing GLUTEN, such as wheat, rye, and barley. It is characterized by INFLAMMATION of the SMALL INTESTINE, loss of MICROVILLI structure, failed INTESTINAL ABSORPTION, and MALNUTRITION. Gluten Enteropathy,Sprue, Celiac,Sprue, Nontropical,Celiac Sprue,Gluten-Sensitive Enteropathy,Sprue,Disease, Celiac,Enteropathies, Gluten,Enteropathies, Gluten-Sensitive,Enteropathy, Gluten,Enteropathy, Gluten-Sensitive,Gluten Enteropathies,Gluten Sensitive Enteropathy,Gluten-Sensitive Enteropathies,Nontropical Sprue
D002855 Chromatography, Thin Layer Chromatography on thin layers of adsorbents rather than in columns. The adsorbent can be alumina, silica gel, silicates, charcoals, or cellulose. (McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Chromatography, Thin-Layer,Thin Layer Chromatography,Chromatographies, Thin Layer,Chromatographies, Thin-Layer,Thin Layer Chromatographies,Thin-Layer Chromatographies,Thin-Layer Chromatography
D005223 Fats The glyceryl esters of a fatty acid, or of a mixture of fatty acids. They are generally odorless, colorless, and tasteless if pure, but they may be flavored according to origin. Fats are insoluble in water, soluble in most organic solvents. They occur in animal and vegetable tissue and are generally obtained by boiling or by extraction under pressure. They are important in the diet (DIETARY FATS) as a source of energy. (Grant & Hackh's Chemical Dictionary, 5th ed)
D005243 Feces Excrement from the INTESTINES, containing unabsorbed solids, waste products, secretions, and BACTERIA of the DIGESTIVE SYSTEM.
D005260 Female Females

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