Faecal steroids after jejunoileal bypass with 3:1 or 1:3 jejunoileal ratio

The faecal steroid excretion was assessed after jejunoileal bypass with a 3:1 ratio (n = 14) and with a 1:3 ratio (n = 9) between the jejunal and ileal segment left in continuity. The bile acid excretion with a 1:3 bypass was 49% of that with a 3:1 bypass (P less than 0.01), with a slight predominance of chenodeoxycholic over cholic acid in 1:3 compared with 3:1 bypass. The excretion of neutral steroids of cholesterol origin was slightly but insignificantly higher with a 1:3 bypass. Accordingly, the faecal bile acids contributed significantly less to total faecal steroids with a 1:3 bypass. The net sterol loss was higher, although not significantly so, with a 3:1 than with a 1:3 jejunoileal ratio. The study indicates that the 1:3, compared with the 3:1, jejunoileal ratio of the bypass reduces bile acid excretion considerably, whereas the effect on cholesterol turnover appears to be less pronounced.