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. 1977 Oct;18(10):792–794. doi: 10.1136/gut.18.10.792

Use of an elemental diet (Vivonex) in the management of bile acid-induced diarrhoea.

L M Nelson, H A Carmichael, R I Russell, S T Atherton
PMCID: PMC1411685  PMID: 590836

Abstract

The effect of a low fat containing elemental diet (Vivonex) on faecal bile acid excretion was studied in six patients with cholerheic diarrhoea, two normal controls, and four patients with non-cholerheic diarrhoea. The total faecal bile acid excretion for the patients with bile acid-induced diarrhoea was significantly reduced fron 6-37+/- 1-64 mmol/24 h (mean +/- SEM) to 2-70 +/- 1-12 mmol/24 h during Vivonex treatment (p less than 0-05). A marked improvement in the diarrhoea of these patients occurred; the number of stools per day decreased and there was less urgency associated with the diarrhoea. No significant reduction in faecal bile acid excretion was observed for the control and non-cholerheic diarrhoea groups. An elemental diet of this type may be of value in the management of patients with bile acid-induced diarrhoea unresponsive to other forms of therapy, and may be of particular value in patients with Crohn's disease.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Attebery H. R., Sutter V. L., Finegold S. M. Effect of a partially chemically defined diet on normal human fecal flora. Am J Clin Nutr. 1972 Dec;25(12):1391–1398. doi: 10.1093/ajcn/25.12.1391. [DOI] [PubMed] [Google Scholar]
  2. Campbell C. B., Spencer J., Dowling R. H. Bile salt secretion and pool size in Rhesus monkeys with controlled interruption of the enterohepatic circulation. Gut. 1969 Dec;10(12):1050–1050. [PubMed] [Google Scholar]
  3. Crowther J. S., Drasar B. S., Goddard P., Hill M. J., Johnson K. The effect of a chemically defined diet on the faecal flora and faecal steroid concentration. Gut. 1973 Oct;14(10):790–793. [PMC free article] [PubMed] [Google Scholar]
  4. Evrard E., Janssen G. Gas-liquid chromatographic determination of human fecal bile acids. J Lipid Res. 1968 Mar;9(2):226–236. [PubMed] [Google Scholar]
  5. Goode A., Hawkines T., Feggetter J. G., Johnston I. D. Use of an elemental diet for long-term nutritional support in Crohn's disease. Lancet. 1976 Jan 17;1(7951):122–124. doi: 10.1016/s0140-6736(76)93159-7. [DOI] [PubMed] [Google Scholar]
  6. Hepner G. W. Effect of decreased gallbladder stimulation on enterohepatic cycling and kinetics of bile acids. Gastroenterology. 1975 Jun;68(6):1574–1581. [PubMed] [Google Scholar]
  7. Hofmann A. F. Bile acid malabsorption caused by ileal resection. Arch Intern Med. 1972 Oct;130(4):597–605. [PubMed] [Google Scholar]
  8. Hofmann A. F., Poley J. R. Cholestyramine treatment of diarrhea associated with ileal resection. N Engl J Med. 1969 Aug 21;281(8):397–402. doi: 10.1056/NEJM196908212810801. [DOI] [PubMed] [Google Scholar]
  9. Hofmann A. F. The syndrome of ileal disease and the broken enterohepatic circulation: cholerheic enteropathy. Gastroenterology. 1967 Apr;52(4):752–757. [PubMed] [Google Scholar]
  10. PORTMAN O. W., MANN G. V., WYSOCKI A. P. Bile acid excretion by the rat: nutritional effects. Arch Biochem Biophys. 1955 Nov;59(1):224–232. doi: 10.1016/0003-9861(55)90479-3. [DOI] [PubMed] [Google Scholar]
  11. PORTMAN O. W., MURPHY P. Excretion of bile acids and beta-hydroxysterols by rats. Arch Biochem Biophys. 1958 Aug;76(2):367–376. doi: 10.1016/0003-9861(58)90162-0. [DOI] [PubMed] [Google Scholar]
  12. Russel R. I. Elemental diets. Gut. 1975 Jan;16(1):68–79. doi: 10.1136/gut.16.1.68. [DOI] [PMC free article] [PubMed] [Google Scholar]

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