The effect of 24-hours continuous somatostatin-14 infusion on the volume of the bile secretion and on the bile composition were studied in seven patients with malignant biliary obstruction who had transhepatic external biliary drainage. The bile acid composition was measured with high performance liquid chromatography (HPLC). Somatostatin infusion significantly reduced the daily bile loss from median 473 ml to 140 ml (41 per cent, p = 0.01) with a concomitant significant reduction in the daily molar loss of cholesterol, triglyceride, Na+, K+, Cl-, Ca+2 and Mg+2. The loss of chloride and sodium was reduced with median 50 mmol/day each (p = 0.01). The relative concentrations of the measured bile constituents did not change significantly, except for bile acids (p = 0.02): the concentration of glycochenodeoxycholic acid increased significantly (p = 0.04). The molar loss of taurocholic acid decreased significantly (p = 0.035), so the increased concentration of glycochenodeoxycholic acid resulted only in a marginally significant reduction in the total molar loss of bile aids (p = 0.051). Somatostatin is a potent inhibitor of bile secretion. The peptide may be used in severely bile depleted patients for reducing their serious electrolyte and acidity problems. Analysis of bile acid composition by HPLC is well suited for further investigations of the regulatory mechanisms of bile acid secretion.

In order to obtain a completely homogeneous mixture of a normal stool it is found necessary only to homogenize the stool samples for 2 min using a paint-can shaker. A method for handling faeces in chemical analyses is based on a freezing procedure in which the homogenized faeces are frozen in a plastic bag separated into different compartments. The frozen faeces can be cut off and weighed for analysis. Compared to the usual method, the plastic bag freezing method is faster and avoids unpleasant smell.

Biliary metabolism in 11 patients with ileum reservoirs with anal anastomosis and a long efferent leg was studied. Eleven healthy persons served as controls. A significantly higher excretion of bile acids was found in the patients, but they seemed to have a normal cholic acid pool size. The bile acids excreted were cholic acid and chenodeoxycholic acid, the so-called primary bile acids, for more than 90%, whereas the normal controls mainly excreted secondary bile acids (deoxycholic acid and lithocholic acid). Fat excretion was generally not increased in the group but was above normal in two patients. Vitamin B12 absorption was subnormal in two patients and was not correlated to bile acid excretion. Bile acid excretion was not correlated to the weight of feces. The bacterial flora was more feces-like than would have been expected from a normal terminal ileum but was correlated neither to the bile acid excretion nor to the quantity of feces. We conclude that the patients showed dysfunction of the terminal ileum with regard to biliary acid absorption comparable to that found in patients with partial ileal resections.

Determination of the correct average content of a constituent in multiple specimens requires measurements of concentration and volume of each specimen. We have evaluated a simplified method by which the mean content is estimated from one concentration determination and the total volume of the specimens. The greatest possible deviation from the correct mean value can be estimated, and is shown in diagrams. It is demonstrated that a simplified method can often be used with little loss of accuracy. The method is exemplified by measurements of lipid and biliary acids in faeces from healthy subjects and from patients with Crohn's disease.

Epidemiological studies lend support to the hypothesis that high-fibre diets might prevent and low-fibre diets might facilitate the formation of cholesterol gall stones. In the present study, the bile compositions after ingestion of oat bran 18 g/day and placebo 18 g/day for 2 X 2 weeks were compared in a randomized, double-blind cross-over study in 6 healthy volunteers. The lithogenic index of bile was not influenced, whereas the following changes (0.05 less than p less than 0.10) occurred: the cholic acid pool was enlarged, the relative proportion of chenodeoxycholate in bile was increased and that of deoxycholate reduced, while cholate remained unchanged. It is concluded that oat bran seems to influence the metabolism of bile acids.