The role of altered bile acid metabolism in the steatorrhea of experimental blind loop.

Although it is well documented that blind loop of the small intestine, either spontaneously occurring (2) or experimentally produced (3-5), is associated with steatorrhea, the mechanism for this abnormality has not been demonstrated. A pathogenic role of bacteria is strongly suggested in this and closely associated conditions by the observations that bacterial overgrowth of the small bowel occurs (6, 7) and that the steatorrhea usually responds to antibacterial therapy (2, 4, 5). In the present study in vivo alteration of bile acid metabolism in dogs with experimental blind loop steatorrhea was investigated. Marked differences from normal were observed, the most notable abnormality being considerable conversion of conjugated to unconjugated acids within the small bowel of the experimental animals. Two experimental findings suggest that this alteration of bile acid metabolism plays a role in blind loop steatorrhea. First, intraluminal micelle formation, a probable step in fat absorption that occurs optimally in the presence of conjugated bile