Bile Acid Panel

Description

The Bile Acid Panel from BiomarkersLabs.com measures total and fractionated serum bile acids — the cholesterol-derived molecules synthesised in the liver, conjugated with glycine or taurine, and secreted into the bile duct to facilitate dietary fat emulsification and absorption in the small intestine. Bile acids undergo an extensive enterohepatic circulation — 95% are reabsorbed in the terminal ileum and returned to the liver via the portal circulation for reconjugation and re-secretion. Bile acid measurement provides clinically important information across three domains: cholestatic liver disease (where impaired biliary secretion causes bile acid accumulation in serum), malabsorption disorders (where impaired ileal reabsorption causes bile acid deficiency and diarrhoea), and gut-liver axis function (where bile acid composition reflects the health of the microbiome-liver-gut signalling axis). Serum bile acid measurement is particularly valuable in pregnancy, where intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-specific liver disorder and is associated with increased risk of stillbirth when total bile acids exceed 40 µmol/L. Specimens processed through CLIA-certified partner laboratories. Results delivered within 3–5 business days. Available in USA · EU · UK · Canada. Licensed practitioners only.

What does this test measure?

Total Fasting Serum Bile Acids — Total serum bile acid concentration after overnight fasting, reported in µmol/L. Normal fasting total bile acids below 10 µmol/L. Elevated fasting bile acids indicate cholestatic liver disease.

Primary and Secondary Bile Acid Fractionation (where included) — Cholic acid, chenodeoxycholic acid, deoxycholic acid, lithocholic acid, and ursodeoxycholic acid fractionation characterising the bile acid composition profile.

Post-prandial Bile Acids (where included) — 2-hour post-meal total bile acids for assessing hepatic bile acid clearance and enterohepatic circulation efficiency.

Clinical indications

Suspected bile acid malabsorption with chronic diarrhoea — bile acid malabsorption (BAM) causes chronic watery diarrhoea indistinguishable from IBS-D; elevated fecal or reduced serum bile acids, combined with SeHCAT testing or fecal bile acid measurement, diagnoses BAM in patients with IBS-D symptoms.

Cholestasis diagnosis and monitoring — serum bile acids rise earlier and more sensitively than bilirubin in intrahepatic cholestasis; elevated fasting bile acids with elevated ALP and GGT characterise cholestatic liver disease.

Intrahepatic cholestasis of pregnancy — total serum bile acids above 10 µmol/L confirm ICP; values above 40 µmol/L are associated with significantly elevated stillbirth risk and require intensified obstetric monitoring and ursodeoxycholic acid therapy.

Post-cholecystectomy diarrhoea assessment — bile acid malabsorption is common after cholecystectomy; bile acid measurement characterises the bile acid excess driving post-cholecystectomy diarrhoea.

Liver disease with gut-liver axis involvement — bile acid composition profiling characterises the microbiome-mediated secondary bile acid production that reflects gut microbiome health and its bidirectional relationship with hepatic function.

Primary biliary cholangitis monitoring — serum bile acids track the effectiveness of ursodeoxycholic acid therapy in primary biliary cholangitis (PBC) alongside ALP and GGT normalisation.

Sample type and collection

Blood (serum) and/or stool depending on panel configuration. Fasting required for serum bile acid measurement (8–10 hours). 3–5 business days. USA · EU · UK · Canada. No New York restriction. CLIA · IVDR · CE · HIPAA · GDPR · PIPEDA. Register free at BiomarkersLabs.com. Licensed practitioners only. Pay per test.