Studies on biliary and fecal bile acids in Crohn's disease. The 2nd report. The effect of ED treatment on bile acid metabolism.:The Effect of ED Treatment on Bile Acid Metabolism

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Longterm enteral hyperalimentation using elemental diet (Elental®, ED) as a primary treatment in non-resected Crohn's disease patients with ileal lesions induced remarkable clinical improvement in 9 patients.The first aim of this study was to investigate the difference of bile acid metabolism between active and remissive phase of Crohn's disease through the analysis of biliary and fecal bile acids pre- and post-treatment. Another aim was to elucidate the various effects of longterm enteral hyperalimentation on bile acid metabolism in Crohn's disease patients.The following results were obtained; 1) The ratio of glycine- to taurine-conjugated bile acids (G/T) in bile and the amount of fecal bile acid excretion increased in active phase of Crohn's disease patients, and returned to normal after longterm ED treatment. 2) During ED treatment, both biliary and fecal G/T values were high, ratio of cholate to chenodeoxycholate in bile increased, bile acid concentration in fecal water increased and proportion of conjugated bile acids in feces decreased markedly.These results suggest that 1) ED treatment improves bile acid malabsorption of active Crohn's disease, and 2) changes of bile acid composition in bile and feces during ED treatment are due to unique constituents and characteristics of ED.
財団法人日本消化器病学会の論文