COMMENTARY
See article on page 266
Depressing acid, deconjugating bile
| The first 150 words of the full text of this article appear below. |
Since the first descriptions of the contaminated small
bowel syndrome, controversy has raged about both its pathogenesis and the mechanism of the malabsorption which often accompanies
it.1-4 One, still popular, theory is that in small bowel
bacterial overgrowth the concentration of conjugated bile acids in the
gut lumen is reduced, by bacterial deconjugation, to levels less than
those required for adequate micelle formation. The result is
malabsorption of fat. However, there is as much controversy over the
part played by bile acid deconjugation in the fat malabsorption of
small bowel bacterial overgrowth as there is about whether
malabsorption per se is an inevitable consequence of colonisation of
the small bowel by colonic bacteria. Clearly, the presentation of this
syndrome varies widely from patient to patient and a full investigation of the relation between events in the intestinal lumen and symptoms would therefore be very useful when considering treatment. However, there
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Gut 1998 42: 266-271.[Abstract] [Full Text] [PDF]
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