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December 4, 1981, Vol 246, No. 22 >
ARTICLE | December 4, 1981

Effect of Chenodiol on the Small Intestine: Title and subTitle BreakUnimpaired Structure and Function During Therapy for Gallstone Dissolution FREE

Silvia Casanova, MD; Aldo Roda, PhD; Davide Festi, MD; Giuseppe Mazzella, MD; Rita Aldini, MD; Franco Bazzoli, MD; Claudia Sama, MD; Antonio M. Morselli, PhD; Luigi Barbara, MD; Enrico Roda, MD
[+] Author Affiliations

Reprint requests to Cattedra di Clinica Medica III, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy (Dr E. Roda).


JAMA. 1981;246(22):2597-2601. doi:10.1001/jama.1981.03320220047024
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References

To test whether long-term oral dosage with chenodiol (chenodeoxycholic acid) used for dissolution of cholesterol gallstones would cause impairment of small-intestinal structure or function, ten patients were studied before and after three months of oral chenodiol administration, 15 mg/kg of body weight per day. Small-intestinal structure was assessed by roentgenogram and intestinal biopsy, using both light and electron microscopy. Small-intestinal function was assessed by xylose, fat and vitamin B12, lactose, and bile-acid absorption. Bile acid metabolism was also characterized by the breath test for deconjugation using carbon dioxide labeled with radioactive carbon 14. No significant abnormalities were found. The results suggest that oral chenodiol administration does not impair intestinal structure or function in doses used for gallstone dissolution.

(JAMA 1981;246:2597-2601)

REFERENCES

1 +
Danzinger RG, Hofmann AF, Schoenfield LJ, et al:  Dissolution of cholesterol gallstones by chenodeoxycholic acid . N Engl J Med 1972;; 286:1-8.
2 +
Iser JH, Dowling RH, Mok HYI, et al:  Chenodeoxycholic acid treatment of gallstones . N Engl J Med 1975;;293:378-383.
3 +
Barbara L, Roda E, Roda A, et al:  The medical treatment of cholesterol gallstones: Experience with chenodeoxycholic acid . Digestion 1976;;14:209-219.
4 +
Low-Beer TS, Schneider RS, Dobbins WD:  Morphological changes of the small intestinal mucosa of guinea pig and hamster following incubation in vitro and perfusion in vivo with unconjugated bile salts . Gut 1970;;11:486-492.
5 +
Teem MV, Phillips SF:  Perfusion of the hamster jejunum with conjugated and unconjugated bile acids: Inhibition of water absorption and effects on morphology . Gastroenterology 1972;;62:261-267.
6 +
Wingate DL, Phillips SF, Hofmann AF:  Effect of glycine-conjugated bile acids with and without lecithin on water and glucose absorption in perfused human jejunum . J Clin Invest 1973;; 52:1230-1236.
7 +
Van de Kamer JH, ten Bokkel Huinik H, Weyers MA:  Rapid method for the determination of fat in feces . J Biol Chem 1949;;177:347-355.
8 +
Schilling RF:  Intrinsic factor studies: II. The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B12 . J Lab Clin Med 1953;;42:860-866.
9 +
Fromm H, Hofmann AF:  Breath test for altered bile acid metabolism . Lancet 1971;;2:621-625.
10 +
Roda A, Roda E, Aldini R, et al:  Determination of 14CO2 in breath and 14C in stool after oral administration of cholyl-1-(14C)-glycine: Clinical application . Clin Chem 1977;;23:2127-2132.
11 +
Sasaki Y, Ilio M, Kameda H:  Measurement of "C lactose absorption in the diagnosis of lactase deficiency . J Nucl Med 1970;;11:360-366.
12 +
Roda E, Aldini R, Mazzella G, et al:  Enterohepatic circulation of bile acids after cholecystectomy . Gut 1978;;19:640-649.
13 +
Van Berge-Henegouwen GP, Hofmann AF:  Pharmacology of chenodeoxycholic acid: II. Absorption and metabolism . Gastroenterology 1977;;73:300-309.
14 +
Cowen AE, Korman MG, Hofmann AF, et al:  Metabolism of lithocholate in healthy man: II. Enterohepatic circulation . Gastroenterology 1975;;69:67-76.
15 +
Ament ME, Shimoda SS, Saunders DR, et al:  Pathogenesis of steatorrhea in three cases of small intestinal stasis syndrome . Gastroenterology 1972;;63:728-747.
16 +
Gullikson GW, Cline WS, Lorenzsonn V, et al:  Effects of anionic surfactants on hamster small intestinal membrane structure and function: Relationship to surface activity . Gastroenterology 1977;;73:501-511.
17 +
Keeling JW, Lamabadusuriya SP, Harries JT:  The effects of pure and micellar solutions of different bile salts on mucosal morphology in rat jejunum in vivo . J Pathol 1976;;118:157-164.
18 +
Shimoda SS, O'Brien TK, Saunders DR:  Fat absorption after infusing bile salts into the human intestine . Gastroenterology 1974;;67:7-18.
19 +
Hofmann AF, Thistle JL:  Chenodeoxycholic acid: Possible intestinal injury . N Engl J Med 1974;;290:405-406.

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1 +
Danzinger RG, Hofmann AF, Schoenfield LJ, et al:  Dissolution of cholesterol gallstones by chenodeoxycholic acid . N Engl J Med 1972;; 286:1-8.
2 +
Iser JH, Dowling RH, Mok HYI, et al:  Chenodeoxycholic acid treatment of gallstones . N Engl J Med 1975;;293:378-383.
3 +
Barbara L, Roda E, Roda A, et al:  The medical treatment of cholesterol gallstones: Experience with chenodeoxycholic acid . Digestion 1976;;14:209-219.
4 +
Low-Beer TS, Schneider RS, Dobbins WD:  Morphological changes of the small intestinal mucosa of guinea pig and hamster following incubation in vitro and perfusion in vivo with unconjugated bile salts . Gut 1970;;11:486-492.
5 +
Teem MV, Phillips SF:  Perfusion of the hamster jejunum with conjugated and unconjugated bile acids: Inhibition of water absorption and effects on morphology . Gastroenterology 1972;;62:261-267.
6 +
Wingate DL, Phillips SF, Hofmann AF:  Effect of glycine-conjugated bile acids with and without lecithin on water and glucose absorption in perfused human jejunum . J Clin Invest 1973;; 52:1230-1236.
7 +
Van de Kamer JH, ten Bokkel Huinik H, Weyers MA:  Rapid method for the determination of fat in feces . J Biol Chem 1949;;177:347-355.
8 +
Schilling RF:  Intrinsic factor studies: II. The effect of gastric juice on the urinary excretion of radioactivity after the oral administration of radioactive vitamin B12 . J Lab Clin Med 1953;;42:860-866.
9 +
Fromm H, Hofmann AF:  Breath test for altered bile acid metabolism . Lancet 1971;;2:621-625.
10 +
Roda A, Roda E, Aldini R, et al:  Determination of 14CO2 in breath and 14C in stool after oral administration of cholyl-1-(14C)-glycine: Clinical application . Clin Chem 1977;;23:2127-2132.
11 +
Sasaki Y, Ilio M, Kameda H:  Measurement of "C lactose absorption in the diagnosis of lactase deficiency . J Nucl Med 1970;;11:360-366.
12 +
Roda E, Aldini R, Mazzella G, et al:  Enterohepatic circulation of bile acids after cholecystectomy . Gut 1978;;19:640-649.
13 +
Van Berge-Henegouwen GP, Hofmann AF:  Pharmacology of chenodeoxycholic acid: II. Absorption and metabolism . Gastroenterology 1977;;73:300-309.
14 +
Cowen AE, Korman MG, Hofmann AF, et al:  Metabolism of lithocholate in healthy man: II. Enterohepatic circulation . Gastroenterology 1975;;69:67-76.
15 +
Ament ME, Shimoda SS, Saunders DR, et al:  Pathogenesis of steatorrhea in three cases of small intestinal stasis syndrome . Gastroenterology 1972;;63:728-747.
16 +
Gullikson GW, Cline WS, Lorenzsonn V, et al:  Effects of anionic surfactants on hamster small intestinal membrane structure and function: Relationship to surface activity . Gastroenterology 1977;;73:501-511.
17 +
Keeling JW, Lamabadusuriya SP, Harries JT:  The effects of pure and micellar solutions of different bile salts on mucosal morphology in rat jejunum in vivo . J Pathol 1976;;118:157-164.
18 +
Shimoda SS, O'Brien TK, Saunders DR:  Fat absorption after infusing bile salts into the human intestine . Gastroenterology 1974;;67:7-18.
19 +
Hofmann AF, Thistle JL:  Chenodeoxycholic acid: Possible intestinal injury . N Engl J Med 1974;;290:405-406.

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