ILEOSTOMY OUTPUT AND BILE-ACID EXCRETION AFTER INTRADUODENAL ADMINISTRATION OF OLEIC-ACID

Background: Ileostomy output and small-intestinal transport are regula ted by complex mechanisms, which the present study aimed to further el ucidate. Methods. The time-related ileostomy output and bile acid excr etion after intraduodenal administration of a fat solution (oleic acid , 3.5 g) was studied in 29 ileostomy patients. Eighteen patients had t he entire small bowel preserved (group I), whereas 11 had various leng ths of the ileum resected or bypassed (group II). Results: Intraduoden al fat administration resulted in a prompt and significant increase in ileostomy output in both groups. The accumulated 2-h output after far administration amounted to 60% of the normal 24-h output in group I a nd 30% in group II, A marked increase in bile acid excretion preceded the flow response. The fat-induced response was abolished by administr ation of cholestyramine. Conclusions: Bile acids seem to have importan t regulatory effects with regard to secretion/absorption and transport of small-bowel contents, affecting ileostomy output, with clinical im plications in many patients.