Primary bile acid malabsorption (PBAM) is an idiopathic intestinal disorder associated with congenital diarrhea, steatorrhea, interruption of the enterohepatic circulation of bile acids, and reduced plasma cholesterol levels. The molecular basis of PBAM is unknown, and several conflicting mechanisms have been postulated. In this study, we cloned the human ileal Na+/bile acid cotransporter gene ...

ABNORMAL lipid metabolism has been implicated as one of the causes of atheroselerosis and coronary artery disease.'-3 Measurements of serum levels of cholesterol, triglycerides, lipoproteins, phospholipids, and total fats, as well as the ul1tracentrifugation of serum, have all demonstrated statistically significant differences between groups of normal subjects and groups of patients with proved...

HYPOTHESIS For patients with head-dominant, small-duct chronic pancreatitis who require operative intervention, pancreatoduodenectomy can be performed safely and affords satisfactory pain relief in most. DESIGN Retrospective case series. Follow-up was complete in 86% of study subjects (average, 6.6 years). SETTING Tertiary care center. PATIENTS Among 484 consecutive cases of chronic pancr...

LTHOUCH chronic exocrine pancreatic insufficiency with marked steatorrhea and azotorrhea is not uncommon, tittle has been writ ten about any associated nutr i t ional deficiency states. Our review of the l i terature reveals no series of cases studied from this point of view, but it is our clinical impression, supported by the published opinions of others, 1-3 that such nutr i t ional deficienc...

Background: Atypical presentations of celiac disease appear to be at least as common as is the classic presentation of steatorrhea, diarrhea, and weight loss. Objective: We examined the effect of a gluten-free diet on gastrointestinal symptoms in a cohort of US patients with celiac disease. Design: A follow-up survey was conducted in 215 patients who were evaluated at the University of Iowa fro...

BACKGROUND Treatment with pancreatic enzymes must be based on an understanding of the normal physiology and pathophysiology of exocrine pancreatic function, as well as of the diseases that cause exocrine pancreatic insufficiency of either a structural or a functional type. These include chronic pancreatitis, pancreatic cancer, cystic fibrosis, pancreaticocibal asynchrony after gastric or pancre...

The effects of (A) H2-receptor antagonist (ranitidine) and enzyme preparation with bile constituents (Digestal forte), (B) Digestal forte and NaHCO3, (C) NaHCO3 alone, or (D) Digestal forte alone, on the increase of lipolysis, were studied in a double-blind, randomized, prospective, controlled cross-over study in 10 patients with chronic pancreatitis (CP) and steatorrhea. All preparations were ...

Studies were carried out to test the hypothesis that abnormal bile salt metabolism (interruption of the enterohepatic circulation) is responsible for steatorrhea in patients with ileal disease and (or) ileectomy.Duodenal bile salt concentration after a single, standard meal eaten at 8 a.m. was measured in 8 patients with ileectomy steatorrhea and compared with 11 normal control subjects and 7 h...