Search

The principal function of large intestinal mucosa is to absorb salt and water. This highly evolved and complexly regulated activity enables the daily ileal effluent of about 1000 ml fluid to be converted into a normally firm stool containing less than 200 ml water and 10 mmol each of sodium, potassium and chloride (Wrong et al. 1981). The aim of this chapter is to review the techniques available to study in man the colorectal mucosal fluxes which enable this modification of ileal output to occur; for reviews of large intestinal mucosal transport itself the reader is referred elsewhere (Powell 1979; Edmonds 1981; Schultz 1981; Wrong et al. 1981; Kerlin and Phillips 1983; Binder and Sandie 1987; Donowitz 1987; Powell 1987).

It has been known for 25 years that nephrolithiasis occurs more commonly in patients with intestinal disease than in the general population (Deren et al. 1962; Gelzayd et al. 1968). The majority of stones in these patients are composed predominantly of calcium oxalate (Gelzayd et al. 1968), and a mechanism to explain this observation became apparent with the demonstration about 15 years ago that individuals with ileal disease or resection excrete increased amounts of oxalate in the urine (Dowling et al. 1971; Admirand et al. 1971; Smith et al. 1972). The aim of this paper is to review present knowledge about the cause, clinical significance and treatment of enteric hyperoxaluria (EHO). In the course of a resume of pertinent aspects of oxalate metabolism, other types of secondary hyperoxaluria will be briefly mentioned.