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Bowel functions and bile Acids in patients with irritable bowel syndrome

May's issue of Clinical Gastroenterology & Hepatology investigates bowel functions, fecal unconjugated primary and secondary bile acids, and colonic transit in patients with irritable bowel syndrome.

News image

There is an unclear relationship among bowel symptoms, excretion of unconjugated fecal bile acid, and colonic transit in irritable bowel syndrome.

Dr Andrea Shin and colleagues measured total and main individual unconjugated fecal bile acid in fecal samples of patients with irritable bowel syndrome (IBS), and assessed relationships among stool frequency or consistency, fecal unconjugated fecal bile acid, and colonic transit.

The team examined 30 healthy volunteers, 31 subjects with irritable bowel syndrome with diarrhea, and 30 with irritable bowel syndrome with constipation.

The patients were placed on 4-day diets containing 100 g fat.

The researchers measured stool characteristics, total fecal unconjugated fecal bile acid and fat levels, and overall colonic transit. 

The team assessed univariate associations of total and individual levels of fecal unconjugated fecal bile acid with phenotype using the Kruskal-Wallis test, and associations between endpoints were assessed using Spearman correlations.

The research team assessed relationships between stool, colonic transit, and fecal total and secretory unconjugated fecal bile acid.

Total fecal unconjugated fecal bile acid was associated with phenotype
Clinical Gastroenterology and Hepatology

There was a significant association between total fecal unconjugated fecal bile acid and phenotype.

The team found that the association was greater for irritable bowel syndrome-D than irritable bowel syndrome-C, compared with controls.

The doctors noted that fecal levels of primary unconjugated fecal bile acid were higher in subjects with irritable bowel syndrome-D, compared with controls.

Levels of fecal secretory unconjugated fecal bile acid were lower in subjects with irritable bowel syndrome-C compared with controls, whereas levels of the nonsecretory unconjugated fecal bile acid, lithocholic acid, were higher.

The researchers found significant univariate associations between stool number and form and total fecal unconjugated fecal bile acid, fecal fat, and colonic transit at 24 and 48 hours after eating.

In the regression models, the relative contribution of colonic transit was consistently greater, and largely independent of the contribution of bile acids.

Dr Shin's team commented, "Measurements of individual unconjugated fecal bile acids identify changes associated with stool characteristics in patients with irritable bowel syndrome."

"These effects are independent of the effects of colonic transit."

Clin Gastroenterol Hepatol 2013
13 May 2013

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