Intraluminal fat digestion and absorption were evaluated in 15 chronic alcoholic and nine healthy volunteer males by aspiration of a standard meal from the jejunum. Intraluminal bile salts were present in normal concentrations and micellar solubilization of fatty acids and monoglycerides was within normal limits. Pancreatic lipase concentrations, however, were significantly lower in the alcoholic patients. As a consequence, hydrolysis of triglycerides was slower resulting in abnormally low concentrations of fatty acids and micellar lipids. Recovery of lipase production toward normal was demonstrated after four to six weeks by repeated intubation studies. Thus, in the chronic alcoholic insufficient production of pancreatic lipase seems to be responsible for the reversible abnormality in the intraluminal digestion of fat.
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