Stool
Bile Acids
Analysis of fats, water content, proteins, starch, sugar, and bile acids in stool.
€ 95,00
All tests
Gut · Stool
Bile acids (feces)
Bile acids in the stool; too many bile acids in the large intestine can cause diarrhea, but a single sample says little.
At a glance
- Measured in stool
- In 2 test panels
- No special preparation
Explanation
Bile acids (feces): what is measured?
Bile acids are made in the liver and reach the gut through the bile. There they help dissolve fat so that it can be absorbed. At the end of the small intestine, most bile acids are absorbed again and returned to the liver. The laboratory measures how many bile acids are in a stool sample. Bile acids that reach the large intestine draw in water and make the stool looser.
What can it detect?
- A sign of bile acid diarrhea (bile acid malabsorption), as a cause of long-lasting diarrhea
Result
What does the result mean?
Bile acids (feces) too high
A lot of bile acids in the stool may fit bile acid diarrhea: the last part of the small intestine then does not properly take the bile acids back up. This occurs after bowel surgery, with Crohn's disease, after gallbladder surgery and sometimes without a clear cause in people with long-lasting diarrhea. A fatty meal or diarrhea from another cause can also raise the value. In the hospital, bile acid diarrhea is diagnosed with a different test, not with a single stool sample.
Bile acids (feces) too low
Few bile acids is usually the normal result. Very few bile acids together with pale, putty-colored stool and dark urine may fit a blocked bile flow, for example due to gallstones. Rarely: a tumor that blocks the bile flow.
After an abnormal result
Without symptoms, an abnormal result from this test usually needs no follow-up. With symptoms that fit poor digestion, the GP can request pancreatic elastase in the stool or a blood test for celiac disease, and if needed refer you to a gastroenterologist or internist (specialist in internal medicine).
Reliability
How reliable is the test?
Food remnants in a single stool sample mainly say something about what you have eaten and how quickly the food passed through the gut. How well the result shows or rules out poor digestion has not been well studied, neither in people without symptoms nor in people with bowel symptoms. If poor fat digestion (malabsorption) is suspected, the specialist may have fat measured in stool collected over a few days. For pancreatic function, pancreatic elastase in the stool has been studied better.
What can affect the result?
- Food in the days before sample collection (fat, meat, raw vegetables, legumes, dairy, sugars) largely determines the result.
- Diarrhea or, on the contrary, constipation changes the result, because the speed through the gut determines how much is digested.
- One stool sample gives a snapshot; the composition differs from day to day.
- Medicines such as laxatives, antibiotics, stomach acid inhibitors, pancreatic enzymes and weight-loss medicines that block fat absorption (orlistat) affect the result.
Who it is for
Who is the test useful for?
Useful for
Because diet strongly determines the result, this test says little in people without symptoms, and even with symptoms it does not identify a cause. With symptoms that may fit poor digestion, such as long-lasting fatty or mushy stools, unintended weight loss or long-lasting diarrhea, testing through the GP is the right route. Pancreatic elastase in the stool and a blood test for celiac disease are then more targeted first tests. With blood in the stool, unintended weight loss or new bowel symptoms after the age of 50, this test is no substitute for a visit to the GP.
How common is it?
There are no Dutch figures on how often an abnormal result for these tests occurs. Bowel symptoms themselves are common: according to the guideline, irritable bowel syndrome affects about 4 in 100 adults. Conditions in which food is truly poorly digested, such as chronic inflammation of the pancreas, are much rarer.
Dutch medical specialists' guidelines (FMS) on irritable bowel syndrome (NHG and NVMDL) and chronic pancreatitis
Get tested
Bile acids (feces): test panels
Bile acids (feces) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and resultsMore explanations
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- Anti-gliadin IgA (feces)
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