Bile Acids, Bowel Dysfunction, 48 Hour, Feces
Use
Quantitation of fecal bile acids aids in screening for IBS‑D and identification of patients with chronic diarrhea who may benefit from bile acid sequestrant therapy. It is used in evaluating patients suspected of having IBS‑D symptoms due to bile acid malabsorption and provides a direct measure of excess bile acids exiting the colon. Elevated total fecal bile acids or percentage of primary bile acids (cholic acid plus chenodeoxycholic acid) supports diagnosis of bile acid malabsorption. Values exceeding established thresholds (e.g., total BA >2337 µmol/48 h, primary BA >10%, or total BA >1000 µmol/48 h with primary BA ≥4%) are indicative of malabsorption.
Special Instructions
Ordering requires following the Bile Acid‑Associated Tests Ordering Guide. If not ordered electronically, the Gastroenterology and Hepatology Test Request (T728) form must be completed, printed, and sent with the specimen. A stool collection kit (24‑, 48‑, 72‑hour kit T291) is required, with multiple containers labeled (e.g., “1 of 4”) and instructions to freeze immediately upon completion and batch‑send all containers together. Patients must follow a fat‑controlled diet (100–150 g/day) for 3 days prior and during collection, and avoid antibiotics, statins, laxatives, bile acid sequestrants, synthetic fat substitutes, and recent barium. Samples must be frozen immediately; aliquoting is required if additional tests are ordered.
Limitations
Bile acids are unstable in stool—samples must be frozen immediately after collection to prevent degradation. Improper specimen collection, handling, or use of inappropriate containers can lead to rejection or interference. All specimens are evaluated for suitability. Reference values are only established for patients ≥18 years; values for younger patients are not established. Interpretation thresholds may vary.
New York Approved
Methodology
Mass Spectrometry (LC-MS/MS)
Biomarkers
LOINC Codes
- 93338-2
- 93337-4
- 93336-6
- 30078-0
Result Turnaround Time
2-9 days
Related Documents
For more information, please review the documents below
Specimen
Stool
Volume
Entire 48‑hour collection (minimum 5 g)
Minimum Volume
5 g
Container
Stool container compliant with shipping requirements (24, 48, 72‑hour kit)
Collection Instructions
Entire 48‑hour collection, label number of containers (e.g., 1 of 4), freeze immediately upon completion, send all containers together, do not use other containers.
Patient Preparation
Fat‑controlled diet (100–150 g fat/day) for 3 days before and during collection; avoid antibiotics (7 days), statins (5 days), laxatives (3 days), bile acid sequestrants and synthetic fat substitutes (24 h), and wait 48 h after barium before collection.
Storage Instructions
Store refrigerated during collection, then freeze immediately after completion.
Causes for Rejection
Improper container use; all specimens will be evaluated for suitability.
Stability Requirements
| Temperature | Period |
|---|---|
| Frozen | 30 days |