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Related Experiment Video

Updated: Jan 3, 2026

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
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Methods for diagnosing bile acid malabsorption: a systematic review.

Ivan Lyutakov1, Francesco Ursini2, Plamen Penchev1

  • 1Clinic of Gastroenterology, University Hospital "Tsaritsa Yoanna - ISUL", Sofia, Bulgaria.

BMC Gastroenterology
|November 16, 2019
PubMed
Summary
This summary is machine-generated.

The 75-Selenium-homotaurocholic-acid-test (75SeHCAT) shows the highest accuracy for diagnosing bile acid malabsorption (BAM). Further research is needed for fecal bile acid and FGF19 assays to improve BAM diagnosis.

Keywords:
Bile acid malabsorptionBiomarkersChronic diarrheaDiagnostic accuracy

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Internal Medicine

Background:

  • Bile acid malabsorption (BAM) is an under-recognized cause of chronic diarrhea.
  • Limited guidance exists for diagnosing BAM, hindering effective patient management.

Purpose of the Study:

  • To systematically review and compare the diagnostic accuracy of various methods for BAM.
  • To identify the most reliable diagnostic tests for BAM in the absence of a gold standard.

Main Methods:

  • Conducted a systematic literature review using PubMed and manual searches.
  • Assessed full papers evaluating diagnostic accuracy of BAM tests, analyzing sensitivity and specificity.
  • Included 16 studies with 2,332 patients, evaluating 75SeHCAT, serum C4, fecal BA, and FGF19.

Main Results:

  • 75Selenium-homotaurocholic-acid-test (75SeHCAT) demonstrated the highest diagnostic accuracy with 87.32% sensitivity and 93.2% specificity.
  • Serum C4 showed 85.2% sensitivity and 71.1% specificity.
  • Fecal bile acid (BA) and fibroblast growth factor 19 (FGF19) assays had lower diagnostic yields, with substantial heterogeneity across studies.

Conclusions:

  • 75SeHCAT is the most accurate diagnostic test for BAM currently available.
  • Serum C4 assay is a viable secondary option for BAM diagnosis.
  • Novel biomarkers are needed for objective BAM detection and improved patient management.