Postprandial serum concentration of individual bile acids in man. Influence of ileal resection.
For the purpose of characterizing the importance of intestinal function in the maintenance of the enterohepatic circulation of individual bile acids, the serum concentrations of cholic acid (C), chenodeoxycholic acid (CD), and deoxycholic acid (D) were determined after a standardized meal. Two groups of subjects were included: 10 healthy controls and 7 patients with ileal resections 20-80 cm long. The bile acid concentrations were determined using a highly specific and accurate gas chromatographic-mass spectrometric technique with the aid of deuterium-labelled internal standards. In patients with ileal resections, only a moderate and early increase was seen in C concentration after a meal, whereas the CD elevation was more pronounced and prolonged. The D concentrations were reduced both after fasting and postprandially. The data indicate that ileal resection results in essentially complete absence of active bile acid resorption and that intestinal uptake via nonionic diffusion is probably dominant, resulting in postprandial rise of mainly CD in serum.