Bile Acid Metabolism and Intestinal Bacterial Flora after Three Types of Intestinal Shunt Operation for Obesity

Abstract

Danö, P., Lenz, K. & Justesen, T. Bile acid metabolism and intestinal bacterial flora after three types of intestinal shunt operation for obesity. Scand. J. Gastroent. 1974, 9, 767–774.

Jejuno-ileal anastomosis in the treatment of 40 obese patients was responsible for changes in the bile acid metabolism, including a decreased bile acid concentration, an increased glycine/taurine ratio, and bile salt deconjugation; furthermore, the number of enterobacteria increased in the upper jejunal juice. Three types of surgery were compared. The change in the bile acid metabolism was most pronounced in patients subjected to type I and type II surgery in whom only 12 cm or 24 cm of the distal end of the ileum functioned. The most abnormal bacterial flora was observed in patients subjected to type III surgery in whom the distal 36 cm of the ileum was left. It is concluded that the change in bile acid metabolism is due to bile acid malabsorption and partly to the abnormal flora in the small intestine.

Key-words::

• Bacterial flora
• bile acids
• bypass operation
• obesity
• types of operation