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The effect of human bile on Bacteroides fragilis in health and disease.

Bacteroides fragilis is generally believed to be stimulated by bile. Although B. fragilis is rarely found in the human duodenum, it is relatively frequent in gall bladder infections. To investigate this paradox, the growth of B. fragilis in the human bile in both health and disease was studied, and compared with the effect of bovine and porcine bile. B. fragilis was stimulated by the bovine bile and inhibited by the porcine bile. The normal human bile was either bacteriostatic or inhibitory whereas bile from cholelithiatic patients, in 50% of cases, stimulated the growth of B. fragilis. This explains the relative prevalence of B. fragilis in cholelithiatic cholecystitis patients although it is not a resident flora of the duodenum.