. Author manuscript; available in PMC: 2015 Jan 1.

Published in final edited form as: Expert Rev Gastroenterol Hepatol. 2013 Nov 25;8(1):49–61. doi: 10.1586/17474124.2014.851599

Table 2. Advantages and disadvantages of bile acid malabsorption diagnostic methods.

BAM diagnostic methods	Advantages	Disadvantages
¹⁴C glycocholate	May identify small bowel bacterial overgrowth	Radiation exposure, β emission, long t_1/2
		Varying normal values
		Positive breath excretion at 2–4 h does not differentiate BAM from small bowel bacterial overgrowth
		Laborious test method (stool collection)

⁷⁵SeHCAT	γ emission, short t_1/2, with decreased radiation to extra-abdominal organs	Not available in the USA
	Well-defined normal values; level of isotope retention predicts response to bile acid sequestrant	Radiation exposure
	Simple test method: two patient visits

Serum C4	No radiation	Fasting sample, diurnal variation
	Normal values reported in adults	Requires further validation
	Not dependent on age, gender or cholesterol	False-positive in liver disease, treatment with statins and altered circadian rhythm
	Simple blood test: one patient visit

Fecal BA	No radiation	Variable daily fecal BA excretion, requires at least 48 h sample
	Measures total and individual BAs	Cumbersome method (stool collection)

BA: Bile acid; BAM: Bile acid malabsorption.

Reproduced with permission from [83].