Clinical use
Marker of cholestasis of pregnancy.
Background
Bile Acids are synthesised in the liver and secreted into the bile. Their function at this point is to facilitate the excretion of fat soluble waste products into the gut. They are reabsorbed from the intestine (where they assist in the absorption of fat soluble substances e.g. Vit K), transported by the portal blood to the liver and then actively reabsorbed with a certain spill-over into the systemic blood flow. This is usually referred to as enterohepatic circulation. In the normal person one-thousandth of the total bile acid pool leaks into the peripheral circulation, escaping the efficient uptake by the liver. The total serum bile acid level thus reflects the synthetic, excretory and re absorptive aspect of liver function. Serum bile acid levels mirror both the initial phase as well as the longitudinal development in liver diseases.
Bile acids are increased in patients with acute hepatitis, chronic hepatitis, liver sclerosis, liver cancer and obstetric cholestatis. Bile Acids can also be estimated in gastric juice as a valuable marker for duodenogastric bile reflux and also in faeces for intestinal disorders. Bile acids are measured in cholestasis during pregnancy. Patients always present with symptoms of itchiness. If left untreated cholestasis could lead to still birth.
Reference ranges
0 – 17 µmol/L
Specimen requirements
Sample type:
- Serum or Lithium Heparin Plasma.
- Fasting sample is preferable.
Sample identification:
- Three patient identifiers from
- Name
- D.O.B.
- Address
- N.H.S. number
- Unit Number
Turnaround time
2 hours