To study the effect of total colectomy for fecal bile acid excretion we examined groups of patients with ulcerative colitis and familial adenomatous polyposis coli 4,8 +/- 2.9 years after surgery. Patients after total colectomy showed a significant higher fecal bile acid excretion compared to healthy persons (mean +/- SD: 190.8 +/- 195.2 mumol/d). The highest fecal output occurred in patients with permanent ileostomies (mean +/- SD: 7595.0 +/- 5651.4 mumol/d), it was significantly higher compared to patients with ileoanal pouch anastomosis (mean +/- SD: 2212.8 +/- 2132.8 mumol/d). The daily fecal output of patients with ileorectal anastomosis (mean +/- SD: 4331.8 +/- 6314.7 mumol/d) is between the results of both other groups without any significance. After total colectomy only primary bile acids were found in each group whereas healthy people had almost identically rates of primary and secondary bile acids in their stools.