Quantitative Changes in Recirculating Bile Salts

Subject Reason for resection or illness Approximate amount resected or bypassed Taurocholate- C Glycocl Half-life (hr) lolate- C  

Pool size estimated from the exponential decline in specific activity of duodenal samples obtained serially after injection of the labeled bile salt (3). 

Similar studies to those described have been performed in only a limited number of patients with ileal disease in the absence of resection or bypass (3,9-11) five with active regional ileitis and two with radiation damage. The results of isotope dilution studies (Table I, Fig. 2), fecal excretion measurements, and measurements of luminal bile salt concentration have thus far been similar to those reported in ileectomized patients, suggesting that inflammatory disease of the ileum per se results in a loss of enterohepatic circulation of bile salts. It is not known whether this absorptive defect is repaired in remission of regional enteritis. The course of this disease is characterized by variations in activity whether or not these defects in bile salt metabolism vary in accordance with this natural history of the disease is one of several questions requiring study. 

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