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Relationship between bile acid malabsorption and pancreatic insufficiency in cystic fibrosis

A M Weber, C C Roy, L Chartrand

    Gut
    |April 1, 1976
    PubMed

    Insights

    Children with cystic fibrosis (CF) and pancreatic insufficiency exhibit significantly increased bile acid (BA) loss in stools. This malabsorption is linked to pancreatic dysfunction and correlates with fat loss, suggesting impaired digestion.

    Area of Science:

    • Gastroenterology
    • Pediatric Medicine
    • Biochemistry

    Background:

    • Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, including the pancreas.
    • Pancreatic insufficiency in CF leads to maldigestion and malabsorption of nutrients.
    • Bile acids (BA) are crucial for fat digestion and absorption.

    Purpose of the Study:

    • To quantify bile acid (BA) loss in children with cystic fibrosis (CF) and pancreatic insufficiency.
    • To investigate the relationship between BA loss, fat malabsorption, and pancreatic enzyme status.
    • To explore the effect of pancreatic enzyme supplements and dietary modifications on BA and fat excretion.

    Main Methods:

    • Measurement of fecal bile acid (BA) and fat excretion in children with CF (with and without pancreatic insufficiency) and healthy controls.
    • Analysis of BA and fat loss in CF patients before and after pancreatic enzyme supplementation.
    • Evaluation of BA patterns in various gastrointestinal conditions, including CF and ileal resection.

    Main Results:

    • Significantly elevated fecal BA loss (751.1 ± 48.3 mg/m2/24h) was observed in CF children with pancreatic insufficiency compared to controls (109.8 ± 9.8 mg/m2/24h).
    • A strong correlation was found between increased bile acid (BA) and fat malabsorption in CF patients.
    • Pancreatic enzyme supplementation reduced fat loss but did not significantly alter BA excretion.

    Conclusions:

    • Increased fecal bile acid (BA) loss is a common finding in children with cystic fibrosis (CF) and pancreatic insufficiency.
    • The mechanism of increased BA loss in CF is not fully understood but is related to pancreatic insufficiency.
    • Further research is needed to confirm if unhydrolyzed triglycerides interfere with intestinal BA absorption in CF.

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