Jejunal bile salts and microflora in patients with partial gastrectomy

Bile acids and microflora were studied in the proximal jejunum in 31 patients with Billroth I or II gastrectomy. At least 10(5) bacteria/ml., most frequently aerobic or facultative aerobic organisms, were isolated in 25 patients. Deconjugation diminished considerably in only three of seven patients with bile salt deconjugation treated with clindamycin. The relationship between bacterial overgrowth, deconjugation, steatorrhea, cholesterolemia and the relationship between bile salt concentration after testmeal and steatorrhea, are discussed. Bacterial overgrowth and bile salt deconjugation are only minor causes of steatorrhea in this series.