Studies on biliary and fecal bile acids in Crohn's disease (The 1st report) - Comparison of non-resected cases and resected ones. : Comparison of Non-Resected Cases and Resected Ones

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In order to clarify the influence of ileal lesions or ileal resections in Crohn's disease on bile acid metabolism, we investigated bile acid composition of bile and feces in 14 patients with non-resected Crohn's disease (NCD), 2 ileitis and 12 ileocolitis, and 5 patients with ileal resection more than 100cm (RCD). Bile acids in bile and feces were analyzed by high-performance liquid chromatography and enzymatic method using 3α-hydroxysteroid dehydrogenase, respectively.The following results were obtained; 1) Both NCD and RCD patients had decreased concentration of biliary bile acids and increased amount of fecal bile acid excretion, and 2) NCD patients had normal or slightly increased amount of fecal fat excretion and increased bile acid concentration in fecal water, while RCD patients had markedly increased fecal fat and a decreasing tendency to fecal bile acid concentration. Even considering dilution of bile acid concentration with increased fecal volume in both groups, these results suggest bile acid diarrhea is dominant in NCD and fatty acid diarrhea is dominant in RCD.The ratio of glycine-to taurine-conjugated bile acids (G/T) in bile had positive correlation with the amount of fecal bile acid excretion. NCD with extensive ileal lesions and RCD had increased G/T in bile while NCD with localized ileal lesions had normal to slightly increased G/T.