Bile acid analysis: methods and problems.

Abstract

What is the ideal method for analysis of faecal bile acids? Selection of an ideal system for a specific situation requires consideration of several factors, eg the information sought, availability of equipment and time constraints. Each laboratory will select procedures based on these constraints. A situation in which a large number of subjects are to be screened for total bile acid concentration might suggest use of single-day collections, lyophilization prior to homogenization, extraction using the Evrard and Janssen method and quantification by 3 alpha-hydroxysteroid dehydrogenase. However if the ratio of glycine to taurine conjugates and the daily excretion were of interest, separation of subclasses with Lipidex 1000 followed by both gas chromatography (of free bile acids) and HPLC (of conjugated bile acids) would be selected. There is not a best method for all situations. What does the future hold for improving this methodology in order to improve our ability to use faecal bile acid analysis clinically? The biggest problem facing the application of faecal bile acid analysis to clinical situations in the lack of ability to devise a rapid method (24-48 h) which retains the accuracy of current methods. One promising development is the potential application of immunological methods to faecal bile acids. These detection methods have been applied primarily to serum to date but if extraction and/or purification methods could be coupled with this method of quantification, a clinically acceptable method may result.(ABSTRACT TRUNCATED AT 250 WORDS)