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Serum Unconjugated Bile Acids and Small Bowel Bacterial Overgrowth in Pediatric Intestinal Failure: A Pilot Study

David Galloway1, Ethan Mezoff2, Wujuan Zhang3

  • 1Division of Gastroenterology, Hepatology and Nutrition, University of Alabama at Birmingham, Birmingham, Alabama, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|July 24, 2018
PubMed

Insights

Serum unconjugated bile acid (SUBA) levels are elevated in children with intestinal failure (IF) and suspected small bowel bacterial overgrowth (SBBO). Measuring SUBA may help diagnose SBBO in these children.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Microbiology

Background:

  • Children with a history of intestinal failure (IF) are at risk for small bowel bacterial overgrowth (SBBO).
  • Accurate diagnosis of SBBO in this population can be challenging.

Purpose of the Study:

  • To determine serum unconjugated bile acid (SUBA) levels in children with IF and suspected SBBO.
  • To evaluate SUBA as a potential diagnostic marker for SBBO in children with IF.

Main Methods:

  • A case-control pilot study was conducted.
  • Serum bile acids were measured using liquid chromatography-mass spectrometry.
  • Small bowel fluid sampling was performed for microbial culture analysis.

Main Results:

  • SUBA concentrations were significantly higher in children with IF and suspected SBBO compared to controls.
  • Chenodeoxycholic acid (CDCA), a specific SUBA, was elevated in IF subjects with positive SBBO aspirates.
  • Treatment for SBBO did not significantly alter SUBA concentrations.

Conclusions:

  • Elevated SUBA levels are associated with IF and SBBO in children.
  • CDCA may be a key indicator of SBBO in this cohort.
  • SUBA measurement shows promise as a non-invasive diagnostic tool for SBBO in children with IF, potentially serving as a surrogate for fluid aspiration.
Abstract

Keywords:
bacteriabile acidsintestinal failureovergrowthpediatricshort gut

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