ANAEROBIC BACTERIA AND DECONJUGATED BILE SALTS IN THE UPPER SMALL INTESTINE OF INFANTS WITH GASTROINTESTINAL DISORDERS

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Abstract
Challacombe, D. N., Richardson, J. M. and Edkins, S. (Institute of Child Health, University of Birmingham, Birmingham, England). Anaerobic bacteria and deconjugated bile salts in the upper small intestine of infants with gastrointestinal disorders. Acta Paediat Scand, 63: 581, 1974.—Deconjugated bile salts have been reported in the upper small intestine of infants with protracted diarrhoea and secondary mono‐saccharide intolerance. As deconjugated bile salts inhibit monosaccharide transport mechanisms in the small intestine of experimental animals both in vivo and in vitro, they may also cause monosaccharide malabsorption in these infants. In this study infants and children with protracted diarrhoea have been challenged with oral sugar loads to detect patients with glucose or lactose intolerance. The duodenal juice of all infants with protracted diarrhoea was examined by thin layer chromatography and fluonmetry for deconjugated bile salts and cultured anaerobically for bacteria with known deconjugating properties. In addition duodenal juice from infants and children with other gastrointestinal disorders was similarly studied. Deconjugated bile salts and obligate anaerobic bacteria were only associated in two out of thirty samples of duodenal juice, one from an infant with secondary lactose intolerance, and one from an infant with unexplained failure to gain weight. The absence of deconjugated bile salts in the duodenum of two infants with secondary monosaccharide intolerance and from other infants with protracted diarrhoea, does not support the suggestion that the action of deconjugated bile salts on the small intestinal mucosa, is an important causative factor in these disorders.