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Bile acid dysfunction after clam enterocystoplasty

J W Barrington1, H Fern-Davies, R J Adams

  • 1Department of Urology, Cardiff Royal Infirmary, UK.

British Journal of Urology
|August 1, 1995
PubMed
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Clam enterocystoplasty can cause bowel dysfunction by disrupting bile acid circulation. This condition, identified by bowel frequency charts, can be effectively treated with anion-exchange resins.

Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Bile Acid Metabolism

Background:

  • Clam enterocystoplasty is a surgical procedure with a known incidence of post-operative bowel dysfunction.
  • The exact cause of this dysfunction remains incompletely understood in a subset of patients.

Purpose of the Study:

  • To investigate the role of enterohepatic circulation of bile acids in post-clam enterocystoplasty bowel dysfunction.
  • To identify diagnostic markers and therapeutic strategies for this specific complication.

Main Methods:

  • Studied 14 symptomatic patients post-clam enterocystoplasty.
  • Utilized bowel frequency charts, hydrogen breath tests, and 75Se-labelled homocholic acid-taurine (SeHCAT) retention.
  • Administered anion-exchange resins to patients with abnormal SeHCAT results.

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Main Results:

  • Interruption of bile acid circulation, indicated by low SeHCAT retention, was observed in most patients.
  • Hydrogen breath tests ruled out bacterial overgrowth as a cause of diarrhea.
  • Bowel frequency correlated with SeHCAT retention, and anion-exchange resins effectively managed symptoms with good compliance.

Conclusions:

  • Bowel dysfunction after clam enterocystoplasty can result from disrupted enterohepatic circulation of bile acids.
  • Bowel frequency charts and SeHCAT provide diagnostic utility.
  • Anion-exchange resins offer a viable treatment option for affected patients.