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Gallstones cholestyramine

Calcification of the biliary tree with cholestyramine feeding has been reported (93,96). Gallstone formation has been induced (97) and prevented (98) with cholestyramine in animals. The effects of cholestyramine on bile salt synthesis are discussed in a preceding section. [Pg.79]

Bile acids have two major functions in man (a) they form a catabolic pathway of cholesterol metabolism, and (b) they play an essential role in intestinal absorption of fat, cholesterol, and fat-soluble vitamins. These functions may be so vital that a genetic mutant with absence of bile acids, if at all developed, is obviously incapable of life, and therefore this type of inborn error of metabolism is not yet known clinically. A slightly decreased bile acid production, i.e., reduced cholesterol catabolism, as a primary phenomenon can lead to hypercholesterolemia without fat malabsorption, as has been suggested to be the case in familial hypercholesterolemia. A relative defect in bile salt production may lead to gallstone formation. A more severe defect in bile acid synthesis and biliary excretion found secondarily in liver disease causes fat malabsorption. This may be associated with hypercholesterolemia according to whether the bile salt deficiency is due to decreased function of parenchymal cells, as in liver cirrhosis, or whether the biliary excretory function is predominantly disturbed, as in biliary cirrhosis or extrahepatic biliary occlusion. Finally, an augmented cholesterol production in obesity is partially balanced by increased cholesterol catabolism via bile acids, while interruption of the enterohepatic circulation by ileal dysfunction or cholestyramine leads to intestinal bile salt deficiency despite an up to twentyfold increase in bile salt synthesis, to fat malabsorption, and to a fall in serum cholesterol. [Pg.192]

A drug which binds bile salts and causes them to be excreted in the stool. By this effect, it tends to reduce blood cholesterol because a more rapid breakdown of cholesterol is needed to produce bile acids that are lost in the stool. Under certain conditions cholestyramine may also help to dissolve gallstones. [Pg.200]

Another experimental approach to gallstone therapy is the use of phenobarbital. In Rhesus monkeys it increases bile salt and phospholipid secretion into bile without significantly changing cholesterol secretion.98 Furthermore, it has been reported to decrease cholesterol saturation in hepatic bile in man.99 Phenobarbital s ability to decrease the relative cholesterol content in bile may allow dissolution of cholesterol gallstones after long-term therapy. Neither lecithin nor cholestyramine are effective in human gallstone disease.100... [Pg.179]


See other pages where Gallstones cholestyramine is mentioned: [Pg.261]    [Pg.605]    [Pg.427]    [Pg.191]    [Pg.160]    [Pg.164]    [Pg.168]    [Pg.169]    [Pg.278]    [Pg.175]   
See also in sourсe #XX -- [ Pg.160 , Pg.164 ]




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