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G. Donald Cousar, MD; Thomas R. Gadacz, MD

Arch Surg. 1984;119(9):1018-1020.

Abstract
• Following a gastric operation (and occasionally in other patients), biliary reflux may damage the stomach mucosa. If severe damage occurs, a diverting Roux-en-Y procedure may be required. In most cases, nonoperative treatment is successful. Since bile salts have been implicated as a cause of mucosal injury, we evaluated the efficacy of antacids in binding these salts. Several bile salts were mixed with certain antacids and with cholestyramine resin, and the adsorption was determined. Cholestyramine resin absorbed 90% to 97% of the bile salts. At a pH of 7, magaldrate (Riopan) absorbed the dihydroxy—bile salts as well as cholestyramine resin, but the other antacids we tested showed poor adsorption. The ability of antacids to bind bile salts must be considered when treating bile salt—induced injury with these substances.

(Arch Surg 1984;119:1018-1020)

Author Affiliations
From the Department of Surgery, Baltimore Veterans Administration Medical Center; and The Johns Hopkins Hospital, Baltimore.

Footnotes
Accepted for publication May 9, 1984.

Reprint requests to Surgical Service, VA Medical Center, 3900 Loch Raven Blvd, Baltimore, MD 21218 (Dr Gadacz).

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