Pancreatic Society of Great Britain and Ireland: Annual Meeting, 1980: Role of pH-dependent bile acid precipitation in fat maldigestion due to pancreatic steatorrhoea. Preliminary communication.

In pancreatic steatorrhoea due to cystic fibrosis (CF) a major proportion of the meal enters the jejunum below the critical pH of 5, causing bile acid (BA) precipitation and limiting aqueous solubilisation of lipid. Treatment with pancreatin alone results only in a small increase in lipolysis as the lipase is largely inactivated; aqueous lipid solubilisation is not improved as BA precipitation remains a limiting factor. Treatment with cimetidine alone, by reducing BA precipitation, improves lipid solubilisation without improving lipolysis. Treatment with cimetidine and pancreatin reduces pancreatic lipase inactivation and BA precipitation leading to the greatest improvement in lipid solubilisation.