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
THOMAS M. MALM. Cholestyramine and Gallstones. Ann Intern Med. 1974;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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