A single test strategy using spot fecal bile acid test may be a feasible strategy for the diagnosis of bile acid malabsorption.

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY

Indian Journal of Gastroenterology Pub Date : 2026-03-19 DOI:10.1007/s12664-026-01972-y

Shubham Mehta, Samagra Agarwal, Aditya Vikram Pachisia, Vikas Sachdev, Ankit Agarwal, Dwarakanathan Vignesh, Ashish Chauhan, Divya Madan, Bodhisattya Roy Chaudhari, Shubham Prasad, Radhika Sarda, Abhinav Sengupta, Mahendra Singh Rajput, Saurabh Kedia, Vineet Ahuja, Govind K Makharia

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引用次数: 0

Abstract

Background: Bile acid malabsorption (BAM) is often missed in patients with chronic diarrhea as diagnostic tests are technically challenging and not available widely. Quantitative estimation of fecal bile acids (FBA) in a single stool sample has been reported recently for the diagnosis of BAM and may be easily applied.

Methods: We performed a pilot observational cross-sectional study to estimate the optimal FBA cut-point for the diagnosis of BAM, using the IDK^® Bile Acid test, an enzymatic spectrophotometry-based assay for measuring total stool bile acids. We estimated FBA concentrations in healthy adults (n = 100; negative controls) and patients with known ileal Crohn's disease (n = 67; positive controls), generating a receiver-operator characteristics (ROC) curve for assessing its diagnostic accuracy. FBA levels were then assessed in three groups of patients, namely diarrhea-predominant irritable bowel syndrome (IBS-D) and functional diarrhea (FD) (n = 100), post-cholecystectomy (n = 100) and ileal tuberculosis (n = 33).

Results: Optimal cut-off point for FBA was identified at 2.8 µg/g (sensitivity = 89.5%; specificity = 92.0%; area under ROC = 0.959 [95%CI = 0.929-0.989]), with median FBA in healthy controls (1.5 [IQR = 0.7-2.2]) being significantly lower than that in patients with ileal Crohn's disease (6.0 [IQR = 4.7-8.0]; p < 0.001). Median FBA in patients with IBS-D/FD, post-cholecystectomy and those with ileal tuberculosis were 2.0 (IQR = 1-2.8), 3.4 (IQR = 1.7-5.3) and 3.0 (IQR = 2.2-4.6), respectively. Overall, 21%, 57% and 54.5% of patients with IBS-D/FD, post-cholecystectomy and ileal tuberculosis had BAM.

Conclusions: We demonstrate the feasibility of quantitative estimation of fecal bile acids in a single stool sample to diagnose BAM.

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粪胆汁酸斑点试验是诊断胆汁酸吸收不良的一种可行的方法。

背景：胆汁酸吸收不良（BAM）在慢性腹泻患者中经常被遗漏，因为诊断测试在技术上具有挑战性且不广泛可用。定量估计单个粪便样本中的粪胆汁酸（FBA）最近被报道用于诊断BAM，并且可能很容易应用。方法：我们进行了一项前瞻性的观察性横断面研究，以估计诊断BAM的最佳FBA切点，使用IDK®胆汁酸试验，一种基于酶促分光光度法的测定粪便总胆汁酸的方法。我们估计了健康成人（n = 100，阴性对照）和已知回肠克罗恩病患者（n = 67，阳性对照）的FBA浓度，生成接受者-操作者特征（ROC）曲线，以评估其诊断准确性。然后评估三组患者的FBA水平，即腹泻型肠易激综合征（IBS-D）和功能性腹泻（FD）（n = 100），胆囊切除术后（n = 100）和回肠结核（n = 33）。结果：确定了FBA的最佳截断点为2.8µg/g（敏感性= 89.5%，特异性= 92.0%，ROC下面积= 0.959 [95%CI = 0.929-0.989]），健康对照的中位FBA （1.5 [IQR = 0.7-2.2]）显著低于回肠克罗恩病患者的中位FBA (6.0 [IQR = 4.7-8.0])； p结论：我们证明了定量估计单个粪便样本中粪便胆汁酸诊断BAM的可行性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.90

自引率

10.00%

发文量

期刊介绍： The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.