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Published on: November 27, 2016
Bile Acid Malabsorption Panel in Patients with Treated Neuroendocrine Tumors
Ayah Matar1, Thorvardur R Halfdanarson2, Mohamad B Sonbol2,3
1Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, 200 First St. S.W, Charlton Building, Rm. 8-110, Rochester, MN, 55905, USA.
Purpose:
Patients with neuroendocrine tumors experience diarrhea due to bioactive products of neuroendocrine tumors, bile acid malabsorption, or small bowel resection. We previously validated a bile acid malabsorption panel based on single stool primary bile acid (> 10%) and fasting serum C4 (> 52.5 ng/mL) to diagnose bile acid malabsorption.
Methods:
Our aim in this study was to audit diagnosis of bile acid malabsorption using the bile acid malabsorption panel in patients with treated neuroendocrine tumors compared with patients with functional diarrhea.
Results:
Bile acid malabsorption was identified in 14/23 (61%) patients with neuroendocrine tumors based on combined C4 and single stool primary bile acid. Bile acid malabsorption was more prevalent in patients with NET than in patients with functional diarrhea as demonstrated by significantly higher primary bile acids and serum C4.
Conclusion:
The bile acid malabsorption panel is a feasible convenient test to positively diagnose bile acid malabsorption in patients with neuroendocrine tumors.