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Henry Ford Hospital Medical Journal

Abstract

The effects of a mucoid - psyllium hydrocolloid - and an anion exchange polymercholestryamine - on the total cholesterol, total phospholipid, total bile salt, cholate, chenodeoxycholate, and deoxycholate concentrations of hepatic bile were determined in six post-cholecystectomy patients. Bile was obtained by drainage through an indwelling T-tube, which was clamped except during bile collection. Psyllium hydrocolloid treatment (12 gm/day) for 6 to 29 days had little or no effect on the cholesterol or phospholipid concentration of hepatic bile, but increased the total bile salt pool by gradually increasing the concentration of deoxycholate. Cholestyramine treatment (12 gm/day) for 8 to 12 days had no significant effect on cholesterol, phospholipid or total bile salt concentrations. There was a significant increase in the tri- to di-hydroxy bile salt ratio due to decreases in chenodeoxycholate and deoxycholate concentrations. The ratio of taurine to glycine conjugates decreased because of reductions in concentrations of taurine conjugates and compensating increases in glycine conjugates. The influence of these changes on bile micelle stability and cholesterol solubility is discussed. It is concluded that the changes effected by psyllium hydrocolloid may result in more stable bile micelles and greater cholesterol solubility. No definite conclusions can be reached with respect to cholestyramine's effects.

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