Effect of Diet on Biliary Cholesterol

Abstract

It has been shown by us that the actual cholesterol content in bile is not as important in gall stone formation as the ratio of cholesterol to the substance which holds it in solution, namely, the bile salts. In these studies, however, we are mainly concerned with the cholesterol factor of this ratio and the effects produced on it by the administration of fats and lipoids.

Our experiments were performed on 3 dogs, using the Rous 2-way fistula. This method prevents the interruption of the enterohepatic circulation of bile and also minimizes infection of the liver. The administration, by mouth, of olive oil, butter and cream did not increase bile cholesterol. Meat, regarded by some as a precursor of cholesterol, also had no effect, throughout our series. Large amounts of bile acids were also fed by mouth and these produced no effect on either the cholesterol or bile acid content of the bile.

Further observations were made on a diabetic with a common duct tube, from which all the bile was drained for 19 days. The diabetes was mild and well controlled before the operation. For the first few days following the operation she had a slight glycosuria and some acidosis, but she rapidly returned to normal. While no blood cholesterol studies were made, one would expect somewhat of a lipemia in such a case. However, if this was present it was not reflected in an increased bile cholesterol. From the 4th postoperative day to the 12th she was receiving 130 gm. of fat per day. From the 12th to the 15th her diet was diminished to 50 gm. of fat per day. This decrease was likewise not reflected in the biliary excretion of cholesterol.