Evidence for Excessive Absorption of Oxalate by the Colon in Enteric Hyperoxaluria

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Abstract
The site of oxalate hyperabsorption in malabsorption syndromes was studied. Urinary oxalate excretion was measured in 27 patients with ileal resection (IR) and steatorrhea. Mean urinary oxalate excretion was high in 13 patients with IR and intact colon and in 9 subjects with IR and right hemicolectomy (90.2 .+-. 11.9 and 108 .+-. 18.6 mg/24 h; mean .+-. SEM standard error of the mean), whereas it was normal in 5 patients with IR and ileostomy (21.9 .+-. 4.4 mg/24 h). Steatorrhea was similar in the 3 groups. On 1 patient of the last group in whom the colon was not removed initially, closure of the ileostomy resulted in the developmentof frank hyperoxaluria. Intracolonic perfusion of C (1.93 g/day) abolished or greatly reduced the hyperoxaluria in 3 patients. The colon is the major site of oxalate hyperabsorption, the right colon is not necessary for the development of hyperoxaluria in malabsorption syndromes.