Effect of Oral Administration of Dioctahedral Smectite and Cholestyramine with Phototherapy in the Treatment of Neonatal Hyperbilirubinemia

PURPOSE: Dioctahedral smectite is an alumina silicate of phyllitic structure and absorbs bile acid in the intestine, forming a non-absorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of dioctahedral smectite and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shortens the duration of hospitalization and to compare dioctahedral smectite with cholestyramine. METHODS: Total 45 full-term neonate with a total bilirubin level greater than 12 mg/dl were studied. The neonate were randomly divided into three groups : 1) Only phototherapy group (A) 2) 3.0 g/day dioctahedral smectite with phototherapy group (B) 3) 1.0 g/kg/day cholestyramine with phototherapy group (C). RESULTS: The mean serum bilirubin level of group B and C decreased significantly compared to group A at 48, 72 and 96 hours after the beginning of the study. The duration of phototherapy and hospitalization significantly decreased in group B and C. CONCLUSION: The data revealed that oral administration of dioctahedral smectite not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy and can substitute for cholestyramine.

Effect of Oral Administration of Cholestylamine with Phototherapy in the Treatment of Neonatal Hyperbilirubinemia

PURPOSE: Cholestylamine has been shown to release chloride ion and absorbs bile acid in the intestine, forming a nonabsorbable complex preventing enterohepatic circulation. The purpose of this study is to clarify the value of cholestylamine and the adequate dosage, in combination with phototherapy, as well as to confirm whether it shorten the duration of hospitalization. METHODS: Total 80 full-term neonates with a total bilirubin level greater than 12mg/dL were studied. The neonates were randomly divided into four groups : (1) Only phototherapy group (A)(2) 250mg/kg/day cholestylamine with phototherapy group (B)(3) 500mg/kg/day cholestylamine with phototherapy group (C)(4) 1000mg/kg/day cholestylamine with phototherapy group (D). RESULTS: Forty-eight hours, 72 hours and 96 hours after the beginning of the study, the mean bilirubin level among the B, C, D groups significantly diminished than A group (P<0.05). The duration of phototherapy and hospitalization significantly diminished in the D group. After phototherapy, finished mean bilirubin level was markedly diminished in the D group. CONCLUSION: The data revealed that oral administration of cholestylamine (especially 1000mg/kg/ day cholestylamine with phototherapy group : D) not only increased the efficacy of phototherapy, but also shortened the duration of phototherapy.