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Acquired Hyperoxaluria with Regional Enteritis After Ileal Resection: Role of Dietary Oxalate

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The opinions expressed in this paper constitute the private ones of the authors and are not to be construed as reflecting the views of the Navy Department or the Naval Service at large.

Grant Support: U.S. Navy Grant CIP-2-13-010.

Presented in part 12 April 1973, Fifty-Fourth Annual Session of the American College of Physicians, Chicago, Illinois. Portions of this work have appeared in Abstracts of Vth International Congress of Nephrology, 1022, 1972.

▸Requests for reprints should be addressed to John Q. Stauffer, M.D., Department of Medicine, State University Hospital, Upstate Medical Center, Syracuse, NY 13210.

Great Lakes, Illinois

Ann Intern Med. 1973;79(3):383-391. doi:10.7326/0003-4819-79-3-383
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Urinary oxalate excretion was measured in 11 patients with inflammatory bowel disease involving the terminal ileum. Group A consisted of six patients with minimal or no resection of terminal ileum and group B of six patients with resections greater than 30 cm. Basal urinary oxalate excretion was normal in group A but was significantly elevated in group B. After treatment with oral cholestyramine, a drug known to bind bile salts, urinary oxalate excretion fell promptly in group B to within the normal range but remained unchanged in group A. Five of six patients in group B had severe, explosive, watery diarrhea, which was dramatically reversed by cholestyramine. Hyperoxaluria in two patients was reversed when oxalate was removed from the diet, and in-vitro studies showed that cholestyramine binds oxalic acid. These data suggest that the mechanism of acquired hyperoxaluria in patients with ileal resection is related to enhanced absorption of dietary oxalate.





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