Bacterial overgrowth in ileal reservoirs (Koch pouch): extended functional studies.

An absorptive, hormonal, bacteriological and morphological study was performed in 9 proctocolectomized patients with continent ileal reservoirs established for 2-57 months. Vitamin B 12 malassimilation (as assessed by the Schilling test and serum vitamin B 12 concentration), bile salt deconjugation (modified 14C-glycocholate breath test), increased stool fat excretion and high intestinal sodium loss with secondary hyperreninism/hyperaldosteronism were encountered in a large percentage of patients; proximal small intestinal absorption (serum parameters, xylose test) appeared intact. In reservoir stool samples total and differential bacterial cell counts yielded values close to a normal rectum flora.