Serum Bile Acids in Relation to Disease Activity and Intake of Dietary Fibers in Juvenile Ulcerative Colitis

Serum concentrations of primary bile acids were determined at different disease activities in juvenile ulcerative colitis and in healthy age-matched controls. In patients with ulcerative colitis in clinical remission, serum levels of bile acids were also studied after long-term intake (6 months) of dietary fibers (wheat fiber and ispaghula, respectively) in a double-blind randomized cross-over study. Blood samples were taken in the morning after an overnight fasting and for 4 h postprandially after a standardized test meal. Determinations of bile acids were made by radioimmunoassays. Patients with total colitis in the active phase had significantly higher serum levels of cholic and chenodeoxycholic acids 4 h postprandially compared with control children. After long-term intake of ispaghula, significantly higher (although not different from controls) serum levels of cholic acid were found 2 and 3 h postprandially, whereas wheat fibers did not affect serum bile acid concentrations. These results may suggest an increased absorption of unconjugated bile acids in the diseased colon and a minimal influence of dietary fibers on serum bile acid concentrations.