THOMAS M. MALM, M.D.
To the editor: Reading the article, "Cholestyramine in Type II Hyperlipoproteinemia," by Levy and associates (Ann Intern Med 79:51-88, 1973), reminded me of the recent paper from the Mayo Clinic (THISTLE JL, SCHOENFIELD LJ, Induced alterations in composition of bile of persons having cholelithiasis. Gastroenterology 61:488-496, 1971), describing the treatment of gallstones with cholic acids. Grossly simplified, the contention of the authors is that alteration of the cholesterol/cholic acid ratio was intimately related to stone formation and that a decrease in cholic acid led to super saturation of cholesterol and hence cholesterol stone formation. The treatment of choice, then, was
MALM TM. Cholestyramine and Gallstones. Ann Intern Med. ;80:120. doi: 10.7326/0003-4819-80-1-120_2
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Published: Ann Intern Med. 1974;80(1):120.
Biliary Disorders, Gastroenterology/Hepatology.
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