Duodenal bile acid concentrations in fat malabsorption syndromes

Meal-stimulated duodenal bile acid concentrations were measured in 38 control subjects and in 138 patients with various gastrointestinal diseases with or without fat malabsorption. In controls, the duodenal bile acid concentrations were normally distributed after Iogarithmic transformation, with a mean of 10.8 mM/1 (range: 5.4-21.5 mM/1). In general, the lower normal limit, 5.4 mM/1, discriminated well between patients with or without steatorrhea in whom other causes of fat malabsorption had been ruled out. The combination of intraluminal bile acid deficiency and steatorrhea was most often encountered in patientswit h hepatic disease, ileal disorders, and in the stagnant loop syndrome. Measurements of duodenal bile acid concentrations may serve to detect disorders of bile acid metabolism and thereby elucidate the pathogenesis of fat malabsorption syndromes.