Role of bile acids in lymphocytic colitis.
OBJECTIVE
A high prevalence of bile acid malabsorption and a high response rate to bile acid binders are seen in collagenous colitis. Our aim was to explore if bile acids play a role in lymphocytic colitis, which is unknown.


METHODS
Patients with lymphocytic colitis completed a diagnostic program, including the 75SeHCAT (75Se-labelled homocholic acid-taurine) test and registration of symptoms. Prevalence of bile acid malabsorption, response to bile acid binders, correlation between 75SeHCAT and histopathology were determined. The 75SeHCAT values were compared with 29 controls.


RESULTS
Two out of 23 with lymphocytic colitis had a 75SeHCAT retention < or = 10%. The median 75SeHCAT value in lymphocytic colitis, 24% (range: 1.7-53), was lower than in the control group, 38% (range: 8-91) (P < 0.02). Forty-six per cent (6/13) responded to bile acid binders. No correlation was found between the 75SeHCAT values and degree of colonic inflammation. Two patients developed collagenous colitis.


CONCLUSIONS
Bile acid malabsorption is more uncommon in lymphocytic colitis than in collagenous colitis. The 75SeHCAT values, however, suggest a role of bile acids in lymphocytic colitis. The conversion of 2 patients to collagenous colitis and disturbed absorption of bile acids also in lymphocytic colitis is consistent with the idea that the two forms represent variants of the same disease.
Ung
Kjell-Arne
KA
Department of Internal Medicine, Division of Gastroenterology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. k.ung@telia.com
Kilander
Anders
A
Willén
Roger
R
Abrahamsson
Hasse
H
D000328:Adult; D001647:Bile Acids and Salts / Q000502:physiology*; D003092:Colitis / Q000503:physiopathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D007408:Intestinal Absorption; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012644:Selenium Radioisotopes; D013656:Taurocholic Acid / Q000031:analogs & derivatives*
D001647:Bile Acids and Salts; D012644:Selenium Radioisotopes; D013656:Taurocholic Acid; C033638:23-seleno-25-homotaurocholic acid