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. 1969 Aug 30;3(5669):494–496. doi: 10.1136/bmj.3.5669.494

Gall Stones in Patients with Disorders of the Terminal Ileum and Disturbed Bile Salt Metabolism*

K W Heaton, A E Read
PMCID: PMC1984313  PMID: 5805332

Abstract

In a combined historical and radiological survey gall stones were found in 23 out of 72 patients with disorders of the terminal ileum (31·9%). This is four to five times the expected incidence of cholelithiasis. In these patients the incidence of gall stones was not related to age, but did, however, increase with increased duration of the ileal disorder. Glycine/taurine conjugation ratios of bile salts in the bile were abnormally high in 10 out of 11 patients with ileal disorders. Both impaired bile salt recirculation and absorption of poorly soluble bacterially degraded bile salts are possible causes of cholelithiasis in these patients.

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Selected References

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

  1. Austad W. I., Lack L., Tyor M. P. Importance of bile acids and of an intact distal small intestine for fat absorption. Gastroenterology. 1967 Apr;52(4):638–646. [PubMed] [Google Scholar]
  2. CHAPIN L. E., SCUDAMORE H. H., BAGGENSTOSS A. H., BARGEN J. A. Regional enteritis: associated visceral changes. Gastroenterology. 1956 Mar;30(3):404–415. [PubMed] [Google Scholar]
  3. GORDON I. R. Cholecystography; observations on the technique of the examination and the interpretation of its results. Q J Med. 1953 Jul;22(87):261–284. [PubMed] [Google Scholar]
  4. HORN G. Observations on the aetiology of cholelithiasis. Br Med J. 1956 Sep 29;2(4995):732–737. doi: 10.1136/bmj.2.4995.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hardison W. G., Rosenberg I. H. Bile-salt deficiency in the steatorrhea following resection of the ileum and proximal colon. N Engl J Med. 1967 Aug 17;277(7):337–342. doi: 10.1056/NEJM196708172770704. [DOI] [PubMed] [Google Scholar]
  6. Heaton K. W., Austad W. I., Lack L., Tyor M. P. Enterohepatic circulation of C14-labeled bile salts in disorders of the distal small bowel. Gastroenterology. 1968 Jul;55(1):5–16. [PubMed] [Google Scholar]
  7. 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]
  8. Jordan P. H., Jr, Olson R., Paige R. Is the gallbladder's reservoir function important after small bowel resection? Surgery. 1968 Aug;64(2):446–450. [PubMed] [Google Scholar]
  9. KOZOLL D. D., DWYER G., MEYER K. A. Pathologic correlation of gallstones: a review of 1,847 autopsies of patients with gallstones. Arch Surg. 1959 Sep;79:514–536. doi: 10.1001/archsurg.1959.04320090162026. [DOI] [PubMed] [Google Scholar]
  10. Krone C. L., Theodor E., Sleisenger M. H., Jeffries G. H. Studies on the pathogenesis of malabsorption. Lipid hydrolysis and micelle formation in the intestinal lumen. Medicine (Baltimore) 1968 Mar;47(2):89–106. doi: 10.1097/00005792-196803000-00001. [DOI] [PubMed] [Google Scholar]
  11. LIEBER M. M. The incidence of gallstones and their correlation with other diseases. Ann Surg. 1952 Mar;135(3):394–405. doi: 10.1097/00000658-195203000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McLeod G. M., Wiggins H. S. Bile-salts in small intestinal contents after ileal resection and in other malabsorption syndromes. Lancet. 1968 Apr 27;1(7548):873–876. doi: 10.1016/s0140-6736(68)90235-3. [DOI] [PubMed] [Google Scholar]
  13. Palmer R. H., Ruban Z. Production of bile duct hyperplasia and gallstones by lithocholic acid. J Clin Invest. 1966 Aug;45(8):1255–1267. doi: 10.1172/JCI105432. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. ROMINGER C. J., LOCKWOOD D. W. Floating gallbladder calculi. Their incidence in a review of one thousand cholecystograms. Am J Surg. 1963 Jul;106:89–93. doi: 10.1016/0002-9610(63)90195-8. [DOI] [PubMed] [Google Scholar]
  15. Schoenfield L. J., Sjövall J., Sjövall K. Bile acid composition of gallstones from man. J Lab Clin Med. 1966 Aug;68(2):186–194. [PubMed] [Google Scholar]
  16. TORVIK A., HOIVIK B. Gallstones in an autopsy series. Incidence, complications, and correlations with carcinoma of the gallbladder. Acta Chir Scand. 1960 Nov 25;120:168–174. [PubMed] [Google Scholar]
  17. Tabaqchali S., Booth C. C. Jejunal bacteriology and bile-salt metabolism in patients with intestinal malabsorption. Lancet. 1966 Jul 2;2(7453):12–15. doi: 10.1016/s0140-6736(66)91744-2. [DOI] [PubMed] [Google Scholar]
  18. Tabaqchali S., Hatzioannou J., Booth C. C. Bile-salt deconjugation and steatorrhoea in patients with the stagnant-loop syndrome. Lancet. 1968 Jul 6;2(7558):12–16. doi: 10.1016/s0140-6736(68)92888-2. [DOI] [PubMed] [Google Scholar]
  19. Van Deest B. W., Fordtran J. S., Morawski S. G., Wilson J. D. Bile salt and micellar fat concentration in proximal small bowel contents of ileectomy patients. J Clin Invest. 1968 Jun;47(6):1314–1324. doi: 10.1172/JCI105823. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Wenckert A., Robertson B. The natural course of gallstone disease: eleven-year review of 781 nonoperated cases. Gastroenterology. 1966 Mar;50(3):376–381. [PubMed] [Google Scholar]
  21. Zaki F. G., Carey J. B., Jr, Hoffbauer F. W., Nwokolo C. Biliary reaction and choledocholithiasis induced in the rat by lithocholic acid. J Lab Clin Med. 1967 May;69(5):737–748. [PubMed] [Google Scholar]

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