The role of bile salts in diarrhoea of patients with ulcerative colitis.

Faecal bile salt elimination, which was determined in patients with ulcerative colitis, was mostly within normal limits, suggesting that in this disease water and electrolyte diarrhoea was hardly contributed to by excessive amounts of bile salts in the large bowel. In a therapeutic trial cholestyramine had no beneficial effect on the general condition, diarrhoea, or faecal composition, findings which further strengthen the view that bile salts play no role in the diarrhoea of ulcerative colitis, provided that the disease is limited to the large bowel. Faecal elimination of cholesterol as bile salts and neutral steroids tended initially to be higher than normal, but increased less than in controls during treatment with cholestyramine, particularly in the heavier patients. Serum cholesterol was low in the patients with ulcerative colitis and decreased by cholestyramine less (27%) than in controls (39%).