Bile Acid Malabsorption: a Complication of Conduit Surgery

We examined the possibility that use of a section of the terminal ileum for ileal conduit construction may impair bile acid absorption and cause choloretic diarrhoea. Nineteen normal subjects (mean age 41 years) and 16 patients with conduits (mean age 47 years) were investigated using the SeHCAT retention test. Conduit patients showed significant impairment of SeHCAT retention compared with normal subjects; 82% of patients had a retention below the lower limit of normal. The mean bowel frequency of patients during the test was 3 motions/day this being significantly different from their pre-operative bowel habit. It was concluded that the use of the terminal ileum in conduit construction may impair bile acid absorption, as measured by the SeHCAT retention test, and may cause an increase in bowel frequency.