1989 Fiscal Year Final Research Report Summary
Establishment of the chemical diagnosis in intestinal diseases with serum bile acid determination
| Project/Area Number |
63570308
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Gastroenterology
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| Research Institution | Institute of Clinical Medicine, University of Tsukuba |
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Principal Investigator |
OSUGA Toshiaki University of Tsukuba Institute of Clinical Medicine Professor, 臨床医学系, 教授 (20010481)
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| Project Period (FY) |
1988 – 1989
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| Keywords | malabsorption / bacterial overgrowth / oral bile acid loading test / serum bile acid profile / unconjugated bile acid / dexycholic acid |
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| Research Abstract |
The increase of unconjugated bile acid (F) or deoxycholic acid (DC) occurred in some gastrointestinal diseases with bacterial overgrowth. The oral UDCA loading test was useful in diagnosing the bile acid malabsorption. Therefore, in order to know the biochemical information of the pathogenesis in the alimentary tract , we tried to distinguish bacterial overgrowth from bile acid malabsorption by combining the determination of serum bile acid profile and oral UDCA loading tests. [Subjects and Methods ] We measured serum bile acid profile in 50 cases with various gastrointestinal disorders and 12 normal controls by HPLC with 3alpha-HSD immobilized column. We performed oral 300mg of UDCA loading test in 16 cases with intestinal diseases. Total serum bile acid was measured by enzymatic fluorometrically. [Results] 1) In 23 out of 52 cases with various gastrointestinal diseases, the percentage of F increased, and in 16 out of 52 cases, DC increased, compared with the one in normal controls. F in the intestinal fluid collected during surgery, increased remarkably as well as the one in serum. 2) In 10 out of 16 cases with intestinal diseases , oral UDCA loading test revealed a significant decrease of exogeneous UDCA compared with the one in normal controls. 3) Using the combination of the oral UDCA loading test and the measurement of serum individual bile acid in 14 cases with intestinal diseases, these could be classified into 4 types as follows ; Type I ; abnormal profile group ( increased F or DC), Type II ; flattened serum bile acid clearance curve, Type III ; both abnormal profile and flattened curve, Type IV ; normal group [Conclusion] The bacterial overgrowth and bile acid malabsorption could be differentiated with using the combination of the measurement of serum bile acid profile and the oral UDCA loading test.
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