New Breath Test for Bile Acid Deconjugation

Bile acids are secreted from the liver as conjugates with glycine and taurine, and, in health, the majority of the bile acid pool is absorbed from the ileum without bacterial deconjugation. In conditions of stasis, when bacteria proliferate in the small intestine, or of ileal disease or resection, when bile acids are poorly absorbed and pass into the colon, increased deconjugation occurs. The article by Sherr et al. in this issue (page 656), as well as a recent report from our own group,1 describes a simple test for altered bile acid metabolism, which measures the extent of bile acid deconjugation. . . .