Serum Bile Acid (SBA) Concentration
Basic Information 
Definition
• Bile: An alkaline liquid secreted by hepatocytes necessary for digestion
• Bile acids (bile salts): Cholesterol conjugates made by the liver and excreted in the bile
• Cholestasis: Any condition in which the flow of bile from the liver is blocked resulting in the accumulation in the blood of components normally secreted in the bile, including bile acids
Physiology
• Bile acids, synthesized by hepatocytes from cholesterol, are necessary for fat digestion and are the primary pathway for cholesterol metabolism. They are secreted in bile. Most (70%–95%) are reabsorbed in the small intestines, removed from portal blood by hepatocytes, and recycled (enterohepatic circulation).
• Bile acids are a test of liver function rather than hepatocellular damage, but contribute to hepatocellular damage when there is cholestasis.
• Bile is continuously secreted into the small intestine of horses, which do not have gall bladders, and only a single point in time sample is necessary for evaluation.
• A reduced total hepatic functional mass decreases bile acid recycling hence serum bile acids are a liver function test. Increases are highly specific to liver disease but not specific to etiology.
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