THE RELATIONSHIP BETWEEN FECAL BILE-ACID PROFILE WITH OR WITHOUT SUPPLEMENTATION WITH CALCIUM AND ANTIOXIDANTS ON RECURRENCE AND GROWTH OF COLORECTAL POLYPS

Faecal bile acids (FBA) have been implicated in colon carcinogenesis. The results of case-control studies of colorectal cancer and polyp pat ients are, however, conflicting. The aim of this study was to examine the influence of faecal bile acids on occurrence, growth and recurrenc e of colorectal polyps, and to see if a mixture of calcium and antioxi dants might possibly act on cancer precursors through the effect on FB A, A total of 116 polyp-bearing patients were recruited from the outpa tients department. Polyps < 10 mm in diameter were left in situ and me asured by annual colonoscopy for 3 years. The patients received placeb o or a mixture of antioxidants and calcium carbonate, 1.6 g calcium io n daily. Faecal samples were collected annually; the first, 1 month af ter start of intervention, freeze dried and subjected to bile acid pro file analysis. Two age and sex matched control groups were recruited ( n = 35), one from healthy volunteers (healthy controls) and one from t he outpatients referred for colonoscopy, with no polyps (hospital cont rols). Twelve of 47 patients from the healthy volunteers had polyps (h ealthy polyp patients). One or more adenomas were found in 93 patients , The faeces of the hospital controls had significantly higher concent rations of total and secondary bile acids than did the healthy control s. There was no difference in FBA profile between the polyp group and the hospital controls, but significantly higher concentration of total and secondary faecal bile acids in the healthy polyp patients compare d with the healthy control group (P < 0.05), No increased concentratio n of FBA were found in the polyp patients with multiple polyps (n = 21 ) or previous treatment for colorectal cancer (n = 7), No associations between FBA profile and growth or recurrence of colorectal polyps wer e found. The polyp patients receiving active medication had higher fae cal concentrations of total and secondary bile acids in the beginning of the study than at the end, in spite of a good compliance, The prese nt study does not support bile acids as being important markers of ini tiation or growth of small and medium sized colorectal adenomas, In th e present study the calcium and antioxidants did not seem to affect th e growth or recurrence of colorectal adenomas by increased TEA excreti on in the faeces, (C) 1998 Lippincott Williams Br Wilkins.