Bile Salt (Fluid)

OVERVIEW

What is bile?

A bile is a greenish yellow secretion by the liver and is passed to gall bladder for concentration, storage & transport into duodenum (first part of small intestine). Bile helps in digestion of body fat. It is composed of bile acids and salts, cholesterol, phospholipids, pigments, water & electrolyte chemicals. Bile salts are made when base neutralizes acid and 4 different kinds of free bile acids namely cholic, chenodeoxycholic, deoxycholic, and lithocholic acid are used. These bile salts act as detergents to emulsify fat (grouping them in small clusters).

What is bile salt (fluid) lab test?

This test is indicated for measuring bile salt level in urine or blood. The test is necessary for evaluation of bile salts as increased bile salt relates to biliary tract (the liver, gallbladder, and bile ducts) obstruction, or liver cell damage. Bile salts appear in urine if there is biliary tract obstruction. Whereas serum bile salts increase if liver disease is present even without biliary obstruction. Deficiency of bile salts leads to precipitation of gallstones (accumulation of solid particles of bile cholesterol and bilirubin in gallbladder).

Why is bile salt (fluid) lab test done?

The test is done:

• As it helps measure bile salt levels in blood or urine
• Bile salt levels whether increase or decrease can indicate towards several disease condition
• Bile salt in urine indicates an obstruction in biliary tract
• Bile salt in blood serum indicates towards various liver diseases.

• For bile salt blood test, blood is taken from vein in an arm via a syringe and collected in small test tube or vial
• For bile salt urine test, urine is collected in a vessel.
• Both the samples are sent to the laboratory for analysis
• The technician performs bile salt test on the respective sample and measures the level of bile salt found in it.

1. Is fasting required for a cholestasis test?

Yes, it is preferred that patients should be fasting. However a 2 hour post-meal level is also used to evaluate liver (hepatic) function.

2. How is bile salt test done?

Rightnow the most sensitive test for detection of intrahepatic cholestasis in pregnancy is by a blood test. It helps measure the level of bile acids and tests also known as bile salt or bile acid salt.

3. Which test is used for bile salt urine detection?

Hay' test or Hay's sulphur flower test is used for detection of presence of bile salts in urine

4. Is drinking water helpful in cholestasis?

In ICP (intrahepatic cholestasis of pregnancy) drinking water helps flush toxins and body system works more efficiently

5. What are the ways by which bile salts can be lowered?

You may start by quit smoking, eat smaller meals, limit fatty food, stay upright after eating, limit alcohol, lose excess weight and raise your bed.

INTERPRETATION OF THE RESULT:

For bile salt urine test:

• Normal range is less than 10 mm/L
• A higher level will indicate positive for obstructive jaundice or liver disease with jaundice

For bile salt blood test:

• Normal range can vary with different methods used and whether the patient (women) is pregnant or non-pregnant.
• As during pregnancy serum bile acid levels become slightly higher.
• Any level or range beyond the normal range will detect liver disease or pruritis in an individual.

You get tested as determination of bile salt levels helps in diagnosis & confirming a liver disease (jaundice), biliary tract obstruction, and pruritus (itching occurs in case of increased serum bile salt) in pregnancy.