UDCA Supplementation Enhances Lipid Digestion and Absorption in Pancreatic Insufficient Patients with Cystic Fibrosis

MARCH 16, 2016
Andrew Smith
Results from a trial involving 23 cystic fibrosis patients with pancreatic insufficiency and mild liver involvement indicate that supplementation with ursodeoxycholic acid can increase the digestion and absorption of fat.
Investigators used a 13C-mixed triglyceride breath test to evaluate fat digestion in patients who took ursodeoxycholic acid and again, in those same patients, after a month without the supplement. Compared to abstinence, the use of ursodeoxycholic acid resulted in a significant increase in cumulative percentage dose recovery (median increase over baseline, 4.6%; interquartile range [IQR], 0.4% to 6.0%, p < 0.00046).
Some patients used both ursodeoxycholic acid and varying amounts of supplemental pancreatic enzymes, a combination that further improved fat metabolism and absorption. Indeed, when the investigators increased enzyme doses in in 16 patients with abnormal 13C-mixed triglyceride breath test results and lipase dose less than 3000 U/g of fat, cumulative percentage dose recovery increased further, (median increase over baseline, 8.6%; IQR, 5.6% to 12.7%; P<0.000027).
The results of ursodeoxycholic acid supplementation were temporary, however. A month without the enzyme saw a significant reduction in fat digestion (P<0.000031) and absorption (median elevation over baseline, 2.9%; IQR, 0.7% to 5.8%).
“Ursodeoxycholic acid supplementation seems to enhance lipid digestion and absorption in pancreatic insufficient cystic fibrosis patients with mild liver involvement,” the investigators wrote in the European Journal of Gastroenterology & Hepatology. “This finding points toward the potential impact of ursodeoxycholic acid supplementation on nutritional status in cystic fibrosis patients with liver disease and underscores the often overlooked role of factors other than pancreatic enzymes on digestion and absorption of fats in cystic fibrosis.”
Ursodeoxycholic acid is a secondary bile acid, created by intestinal bacterial from the primary bile acids that are produced by the liver and stored in the gall bladder.

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