Ileal absorption of bile acids in patients with chronic cholestasis: SeHCAT test results and effect of ursodeoxycholic acid (UDCA)

Dig Dis Sci. 1996 Dec;41(12):2417-22. doi: 10.1007/BF02100137.


The effect of cholestasis on ileal bile acid absorption is controversial in animal models (up- or down-regulation) and unknown in humans. We therefore studied values of the selena homotaurocholic acid (SeHCAT) test before and after long-term administration (>3 months, 13-15 mg/kg/day) of ursodeoxycholic acid (UDCA) in 27 patients with chronic cholestatic liver diseases (24 women, 3 men; mean age, 50 years; 24 primary biliary cirrhosis, 2 secondary biliary cirrhosis, 2 others). The control group consisted of 14 healthy volunteers. Seven-day SeHCAT percentage retention was identical in the 12 untreated cholestatic patients (serum bilirubin, 75+/-42 micromol/L, alkaline phosphatase, 4.2+/-1.0 N; mean+/-SEM) and in the control group (43.6+/-2.9 and 43.8+/-4.2%, respectively). In the 22 patients treated by UDCA for 38+/-8 months, SeHCAT percentage retention was 20.3+/-3.0%. In the seven patients with the SeHCAT test done before and after UDCA treatment (16+/-5 months), SeHCAT percentage retention decreased significantly under UDCA therapy (42.0+/-4.4 vs 19.4+/-4.1%; P < 0.02). We conclude that, in patients with chronic cholestasis (1) SeHCAT percentage retention is not altered-taken together with the known defect of biliary excretion, this lack of increase in SeHCAT percentage retention argues against up-regulation of bile acid ileal transport; and (2) UDCA treatment induces a decrease in the SeHCAT percentage retention-this effect may be related primarily to a decreased bile acid ileal absorption.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Alkaline Phosphatase / metabolism
  • Bile Acids and Salts / metabolism*
  • Cholestasis / complications
  • Cholestasis / drug therapy
  • Cholestasis / metabolism*
  • Chronic Disease
  • Down-Regulation
  • Female
  • Humans
  • Ileum / metabolism*
  • Intestinal Absorption
  • Liver Cirrhosis / complications
  • Male
  • Middle Aged
  • Selenium Radioisotopes / blood*
  • Taurocholic Acid / analogs & derivatives*
  • Taurocholic Acid / blood
  • Up-Regulation
  • Ursodeoxycholic Acid / therapeutic use*
  • gamma-Glutamyltransferase / metabolism


  • Bile Acids and Salts
  • Selenium Radioisotopes
  • Taurocholic Acid
  • Ursodeoxycholic Acid
  • 23-seleno-25-homotaurocholic acid
  • gamma-Glutamyltransferase
  • Alkaline Phosphatase