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2. Tests of Bile-acid and Vitamin B12Metabolism in Ileal Crohn’s Disease

Author

Hans Fromm, Sirus Farivar, Friedrich W. Schmidt, Brittain McJunkin, and Detlef Schindler

Subjects
Adult, Male, medicine.medical_specialty, Malabsorption, Adolescent, medicine.drug_class, Schilling Test, digestive system, Gastroenterology, Bile Acids and Salts, Feces, Crohn Disease, Schilling test, Internal medicine, Humans, Medicine, Ileitis, Vitamin B12, Breath test, Crohn's disease, Bile acid, medicine.diagnostic_test, business.industry, Feces analysis, General Medicine, Middle Aged, medicine.disease, Vitamin B 12, Breath Tests, Female, business
Abstract

The bile-acid breath test, fecal analysis of labeled bile acids, and Schilling test were used to study bile-acid and vitamin B12 metabolism in 31 patients with ileal Crohn's disease. Results of the bile-acid breath test were positive for 42% of the patients; Schilling test, 42%; fecal analysis of bile-acid labels, 19%. Combination of the tests increased the percentage of positive cases to 65. About 50% of the patients who had positive breath tests had evidence of normal bile-acid absorption, indicating increased bile-acid deconjugation by small-intestinal bacteria. The other 50% had evidence of various degrees of bile-acid malabsorption. Disease activity did not correlate with results of any test. Extent of ileal involvement correlated with results of the bile-acid tests, but not with those of the Schilling test. The study demonstrates that there is a wide spectrum of disturbances of bile-acid and vitamin B12 metabolism in ileitis, and that the tests should be useful in the diagnostic evaluation of patients with proven or questionable Crohn's disease who have diarrhea and malabsorptive abnormalities that could be related to disturbances of bile-acid and vitamin B12 metabolism.

Published
1980
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3. Sensitivity of bile acid breath test in the diagnosis of bacterial overgrowth in the small intestine with and without the stagnant (blind) loop syndrome

Author

Hans Fromm, Detlef Schindler, Sirus Farivar, and Friedrich W. Schmidt

Subjects
medicine.medical_specialty, Physiology, medicine.drug_class, Tetracycline, Schilling Test, Biology, Tritium, Gastroenterology, Bile Acids and Salts, Blind loop syndrome, Malabsorption Syndromes, Schilling test, Internal medicine, Intestine, Small, medicine, Humans, Carbon Radioisotopes, Breath test, Bacteria, Bile acid, medicine.diagnostic_test, Bile acid malabsorption, Hepatology, medicine.disease, Chromium Radioisotopes, Small intestine, medicine.anatomical_structure, Breath Tests, Blind Loop Syndrome, medicine.drug
Abstract

The bile acid breath test was studied to examine its sensitivity for establishing the diagnosis of bacterial overgrowth in comparison to that of the Schilling test and small-intestinal cultures in 12 patients with a stagnant (blind) loop syndrome, as well as in 38 patients who had other conditions with suspected bacterial contamination of the small intestine. The presence of bile acid malabsorption was excluded in all 50 patients by studies of fecal excretion of radioactively labeled bile acids. The bile acid breath test was positive in 100% (12/12) of the patients with a stagnant (blind) loop syndrome, whereas 92% (11/12) had a positive Schilling test and 75% (9/12) a positive small-intestinal culture. The abnormal tests improved only in 2 of 4 patients treated with tetracycline. In the group of 38 patients without demonstrable dilated or blind loops of small bowel who were suspected of having bacterial contamination of small bowel, the bile acid breath test was positive in 53% (20/38), the Schilling test in 39% (15/38), and the small-intestinal culture in 45% (17/38). The difference in the incidence of positive results between the tests in the two patient groups was statistically not significant. The findings of these studies have the following diagnostic implications: (1) Bile acid breath test, Schilling test, and cultures of aspirates from the upper small bowel are of comparable sensitivity in the detection of bacterial overgrowth in the small intestine. (2) A negative bile acid breath test makes the diagnosis of a stagnant (blind) loop syndrome very unlikely.

Published
1979
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10. Contributors

Author

Robexrt H. Abeles, Hugo Aebi, Erik Änggard, Norman G. Anderson, Walter Appel, M.H. Aprison, Gilbert Ashwell, Swee E. Aw, Uriel Bachrach, Karl-Heinz Bässler, Eugene S. Baginski, Klaus Beaucamp, Günter Bechtler, Hans Ulrich Bergmeyer, Erich Bernt, Hans-Otto Beutler, Rardon D. Bevill, Heidi Birchmeier, Oscar Bodansky, Paul Boulanger, Karl Brand, Myron Brin, David J.H. Brock, John T. Brosnan, David H. Brown, Joseph G. Brown, Theodor Bücher, Hannes Büttner, Giovanni Ceriotti, James F.A. Chase, Alan Coddington, Patricia S. Cohen, Jack M. Cooperman, Rudolf Czok, Stanley Dagley, Katharina von Dahl, Arne Dahlqvist, Karl Decker, Ulrich C. Dubach, Arnold Eberhard, Fujio Egami, Leonard V. Eggleston, Manfred Eggstein, Frank Eisenberg, Hugo Fasold, William H. Fishman, Piero P. Foà, Edith Förster, Georg Forster, Jörg Frei, Ursula Friebe, Lygia W. Fried, Rainer Fried, Herbert C. Friedmann, Wolf-Peter Fritsch, Hans Fritz, Herbert J. Fromm, Ernest F. Gale, Peter Bryan Garland, Karlfried Gawehn, Ulrich Gerlach, Paul A. Giang, Martin Gibbs, Richard Gitzelmann, Guiseppe Giusti, Heinz W. Goedde, Nelson D. Goldberg, L.T. Graham, Marianne Grassi, Elaine Greenberg, Helmut Greiling, Wolfgang Gruber, Gerd Gundlach, Ingeborg Gutmann, Alexander Hagen, Erich Haid, Hans Haindl, Geoffrey Halliwell, Erwin Hansert, Shin Hasegawa, George G. Hazen, Fritz Heinz, Benno Hess, Peter-Uwe Heuckenkamp, Walter Hiby, John G. Hildebrand, Günther Hillmann, Magnus Hjelm, John R. Hobbs, Norman Joseph Hochella, Thomas Höpner, Helmut Hofner, August W. Holldorf, Günter Holz, Helmut Holzer, Bernhard L. Horecker, Koki Horikoshi, Ronald E. Huribert, Joel Hutzier, Kurt J. Isselbacher, Barbara von Jagow-Westermann, William B. Jakoby, Dieter Jaworek, Mary Ellen Jones, Søren Jørgensen, Wolfram Kaiser, Heinrich Kaltwasser, Reinhard Kattermann, Edna B. Kearney, Dietrich Keppler, John King, Bernard Klein, Martin Klingenberg, Siegmar Klose, Helmut R. Klotzsch, Leiv Klungsøyr, Joachim Knappe, Leonard D. Kohn, Friedrich-Wilhelm Koss, Gladys Krakow, Elisabeth Kuhlmann, Ernest Kun, Gerhart Kurz, Jürgen Kusche, Rudolf Lachenicht, Walther Lamprecht, Gunter Lang, Ulrich Langenbeck, Erwin Latzko, Gerhard Laudahn, Franz Leuthardt, Jacob B. Levine, Alfred Linker, Georg Löffler, Georg Wilhelm Löhr, Karin Löschenkohl, Wilfried Lorenz, Oliver H. Lowry, A. Leonard Luhby, Patricia Lund, Frank Lundquist, Feodor Lynen, Hermann Mattenheimer, Heinrich Matthaei, Claus Maurer, Dieter Mayer, Dieter Mecke, Jane Mellanby, Gerhard Michal, Hans Möllering, Gotthilf Näher, Charles W. Nagel, Robert G. Narins, Erwin Negelein, Heinrich G. Netheler, Eric A. Newsholme, Franz Noll, Hans-Dieter Ohlenbusch, Roger Osteux, Peter Otto, Antonius P.M. van Oudheusden, Paul M. Packmann, Janet V. Passonneau, David J. Pearson, Gerhard Pfleiderer, Wolfgang Pilz, Brunhilde Poppendiek, Jack Preiss, Johann Pütter, Jesse C. Rabinowitz, Efraim Racker, Elli Rauscher, Wirnt Rick, Erwin Rimbach, Peter Röschlau, Carmen Louis Rosano, Jean-François Rouayrenc, Bengt Samuelsson, George E. Schaiberger, Peter Scheibe, William Scher, Helmut Schievelbein, Hans-Günter Schlegel, Ella Schmid, Ellen Schmidt, Felix H. Schmidt, Friedrich W. Schmidt, Helmuth Schmidt, Wilhelm Schoner, Josef Schormüller, Gerhard Schreiber, Christian Schütt, Demoy W. Schulz, Morton K. Schwartz, Gertraud Schweitzer, Werner Seubert, Günther Siebert, Abraham L. Siegel, Wolfgang Staib, Dankwart Stamm, Hans-Peter Stegbauer, Philipp Stein, Harald Stork, Harold V. Street, Bernard L. Strehler, Heinrich Südhof, Szasz Gabor, Shigehiko Taniguchi, Ivar Trautschold, Philip K. Tubbs, Johannes Ullrich, P. Roy Vagelos, Carl-Henrie de Verdier, Peter Vögele, Klaus-Dieter Voigt, August Wilhelm Wahlefeld, Kurt Wallenfels, Hans Dierck Waller, Hans Elmar Walter, Klaus Walter, Otto Warburg, Arthur Weissbach, Herwig Weisser, Eugen Werle, H. Whitney Wharton, Hans-Joachim Wieker, Otto Wieland, Roger Jozef Wieme, J. Henry Wilkinson, Dermot H. Williamson, John R. Williamson, Wolfgang Wilmanns, Irene Witt, Hans-Peter Wolf, Peter Wunderwald, Hans Georg Zachau, Bennie Zak, Gottfried Zankl, Joachim Ziegenhorn, and Nepomuk Zöllner

Published
1974
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13. Contributors

Author

Hans Adam, Robert Ammon, Gilbert Ashwell, Kenneth Bailey, Klaus Beaucamp, Hans-Ulrich Bergmeyer, Paul Bernath, Erich Bernt, Hans Bockendahl, Roger Bonnichsen, Paul Boulanger, David H. Brown, Friedrich H. Bruns, Theodor Bücher, Alan Coddington, Rudolf Czok, Stanley Dagley, Karl Decker, Franz Duspiva, Lieselotte Eckert, Fujio Egami, Hugo Fasold, William H. Fishman, Martin Flavin, Herbert C. Friedmann, Herbert J. Fromm, Ernest F. Gale, Ulrich Gerlach, Paul A. Giang, Heinz Werner Goedde, Paul Greengard, Helmut Greiling, Gerd Gundlach, Geoffrey Halliwell, Cornelis J.A. Hamer, D. van, Alfred E. Harper, Benno Hess, Gerd Hobom, Eduard Hofmann, Hans-Jürgen Hohorst, August Holldorf, Erika Holzer, Helmut Holzer, Bernard L. Horecker, Hans-Dieter Horn, Hans-Joachim Hübener, Kurt J. Isselbacher, Søren Jorgensen, Reinhard Kattermann, Herbert Keller, Martin Klingenberg, Helmut Klotzsch, Joachim Knappe, Gladys Krakow, Stanley P. Kramer, Isidore Krimsky, Ernest Kun, Walther Lamprecht, Erwin Latzko, Irwin G. Leder, Kurt Linhardt, Georg Wilhelm Löhr, Bruno Lorenz, Hans Lück, Frank Lundquist, Carol J. Lusty, Joseph MacGee, Jane Mellanby, Gerhard Michal, George T. Mills, Hans Möllering, Erwin Negelein, Michael Nelböck-Hochstetter, Robert C. Nordlie, Roger Osteux, Gerhard Pfleiderer, Wolfgang Pilz, Elith Praetorius, William E. Pricer, Jesse C. Rabinowitz, Efraim Racker, Martin Reim, Francis J. Reithel, Wirnt Rick, Ellen Schmidt, Friedrich W. Schmidt, Josef Schormüller, Gerhard Schreiber, Arnold M. Seligman, Werner Seubert, Günther Siebert, Thomas P. Singer, Milton W. Slein, Evelyn E.B. Smith, Hans-Dieter Söling, Philipp Stein, Harold V. Street, Bernard L. Strehler, Heinrich Südhof, Shigehiko Taniguchi, Ivar Trautschold, P. Roy Vagelos, Klaus-Dieter Voigt, Hans Dierck Waller, Klaus Walter, Arthur Weissbach, Eugen Werle, Siegfried H.C. de Whalley, William J. Whelan, Otto Wieland, H. Guy Williams-Ashman, Dermot H. Williamson, Irene Witt, Hans-Peter Wolf, Heinz Wüst, and Nepomuk Zöllner

Published
1965
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15. Foreword

Author

David M. Goldberg, Ellen Schmidt, and Friedrich W. Schmidt

Subjects
Clinical Biochemistry, General Medicine
Published
1989
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