How can one explain a fasting bile acids (BA) that is higher than the postprandial bile acids?
There are several possible explanations for this type of result. • Food was not withheld for the 8- 12 hours. • Only 30-50% of the newly formed BA are stored, so there is some secretion of newly formed BA. • There is delayed gastric emptying (highly stressed, or sedated patient) • Postprandial gall bladder contraction releases a variable amount of bile (5 65%), so that the postprandial sample is “lower than expected”. • Bacterial overgrowth augments the unconjugated BA pool, which enter the systemic circulation more readily.
