The role of bile acids in the pathogenesis of postvagotomy diarrhoea

The fecal excretion of bile acids was estimated in patients with postvagotomy diarrhoea, normal control subjects and a control group who had undergone truncal vagotomy and drainage but who did not have diarrhoea. The total daily bile acid excretion in the feces was significantly increased in the postvagotomy diarrhoea group: 2538 ± 632 mg (s.e.m.) compared with 799 ± 117 mg in the normal controls. There was no significant difference between the total daily bile acid excretion in the patients with postvagotomy diarrhoea and that of patients who had undergone vagotomy and drainage but who did not have diarrhoea. A significant increase in the fecal excretion of chenodeoxycholic acid was found in the postvagotomy diarrhoea group compared with the two control groups. This increase may be a factor in the pathogenesis of postvagotomy diarrhoea.