Medium and long chain fat absorption in patients with cirrhosis.

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Abstract
Fat balance studies in 35 patients with alcoholic cirrhosis of the liver revealed fat mal-absorption in 19 (54%). Medium chain triglycerides were significantly better absorbed in a group of 10 cirrhotic patients with malabsorption of long chain triglycerides [LCT]. Absorption rates of octanoic acid from isolated segments of upper small bowel (4-lumen 2-balloon technique) were similar in noncirrhotic and in cirrhotic patients, with or without portacaval shunts. One-third of these cirrhotic patients showed malabsorption of LCT as measured by a fat balance study on a regular hospital diet containing 100 g fat. Mean plasma octanoic acid levels rose from negligible fasting levels to different plateaus during bowel segment perfusion. Control patients showed low levels at all times, while a 2 to 3 fold increase, compared to the control group, was found in the cirrhotic group, probably due to parenchymal disease and portal-systemic shunts. The effects of surgical portacaval shunts were clearly shown by a 3-fold increase of serum octanoic acid levels over those observed in nonoperated cirrhotic patients and by an 8-fold increase over those observed in the control patients. Sodium taurocholate was not absorbed in the upper small bowel and may be useful as a non-absorbable marker for fat absorption studies in the duodenum and proximal jejunum.