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Impaired absorption of cholesterol and bile acids in patientswith an ileoanal anastomosis |
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| Authors: | K Hakala M Vuoristo P Luukkonen H Jarvinen T Miettinen |
| Affiliation: | Department of Medicine, University of Helsinki, Finland. |
| Abstract: | Background—No data exist on cholesterolabsorption in patients with an ileoanal anastomosis (IAA). Aims—To study cholesterol absorption and itseffects on cholesterol and bile acid metabolism in patients with an IAA. Patients and methods—Cholesterol absorption, andserum, biliary, and faecal lipids were studied in 24 patients with anIAA and 20controls. Results—Fractional cholesterol absorption wassignificantly lower in the patients (36% versus 47% in controls).Surprisingly, the calculated intestinal influx of endogenouscholesterol was reduced so that the absolute absorption of cholesterolwas decreased; elimination of cholesterol as faecal neutral steroidsremained normal. Thus, the slightly increased cholesterol synthesis was mainly due to increased faecal bile acid excretion, which, in turn, wasassociated with reduced absorption and biliary secretion of bile acids.Serum total and low density lipoprotein (LDL) cholesterol and LDLtriglycerides were lower in the patients. Molar percentage andsaturation index of biliary cholesterol were slightly higher inpatients with an IAA. Proportions of secondary bile acids in bile andfaeces were diminished, and faecal unidentified bile acids were higherin patients. Conclusions—Cholesterol absorption issignificantly impaired in patients with an IAA, and is closely relatedto changes in serum and biliary lipids observed in these patients. Keywords:cholesterol absorption; cholesterol synthesis; faecal bile acids; inflammatory bowel disease |
| Keywords: | cholesterol absorption cholesterol synthesis faecal bile acids inflammatory bowel disease |