Minimal bile acid malabsorption and normal bile acid breath tests in cystic fibrosis and acquired pancreatic insufficiency.

This study was undertaken because of reports of a marked increase in 
fecal bile acid excretion by children with cystic fibrosis. We attempted 
to confirm this finding by performing [1-14C]cholylglycine breath tests and by 
measuring fecal bile acid and fat excretion in patients with cystic 
fibrosis and acquired pancreatic insufficiency. Studies were done when patients were 
taking pancreatic enzymes (Cotazym) and also without medication. 14CO2 excretion in 
breath was normal in patients with acquired pancreatic insufficiency and even 
lower in cystic fibrosis, both with and without Cotazym therapy. Fecal 
bile acid excretion was slightly elevated in both groups without Cotazym 
and became normal with Cotazym in patients with acquired pancreatic insufficiency. 
Steatorrhea was present in both patient groups and improved during Cotazym 
therapy. Bile acid malabsorption in cystic fibrosis and acquired pancreatic insufficiency 
is minimal and probably not clinically important. 