Bile Acid Deficiency and Constipation

In a nicely performed study on a group of patients with constipation, Vijayvargiya et al1 showed reduced total (particularly dihydroxy secretory) fecal bile acids (BAs), along with the expected decrease in serum 7α-hydroxy-4-cholestene-3-one (a marker for bile acid synthesis) and increased fibroblast growth factor 19 (a factor involved in down-regulating bile acid synthesis). Vijayvargiya et al1 proposed that either "a decreased proportion of secretory fecal bile acids results in constipation" and/or "increased colonic transit time … results in increased passive absorption of fecal BAs and, hence, lower excretion of secretory BAs."

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