IMPAIRED ABSORPTION OF BILE ACID IN THE INFLAMMATORY BOWEL DISEASE: Investigation by Oral Bile Acid Tolerance Test

Absorption of bile acid in patients with bowel diseases, especially with ileocaecal lesion or resection, was studied by oral bile acid tolerance test. From the study of 10 normal controls by enzymatic method, it was found that oral administration of 600mg of unconjugated ursodeoxycholic acid (U.D.C.A.) was most useful for the tolerance test and the peak of total serum bile acid level was 20.9±3.4μM/L at 120 minutes after U.D.C.A. administration. In 7 patients of ileocaecal lesion and 5 patients of resection, 600mg U.D.C.A. tolerance test revealed a flat pattern of total serum bile acid curve, and it showed 9.5±2.0μM/L and 7.6±0.6μM/L at 120 minutes, respectively. These values were significantly lower than 20.9±3.4μM/L of normal controls. Peak values in all the patients were also significantly lower than those of normal controls. Consequently, it is suggested that the tolerance test by 600mg of unconjugated ursodeoxycholic acid is of great use to evaluate the impaired absorption of bile acid in patients with ileocaecal disorders.