Biliary deoxycholate in patients with alcoholic cirrhosis.

Deoxycholate (DC) metabolism was studied in 10 patients with biopsy-proved alcoholic cirrhosis. DC was absent from the bile of 3, present in reduced quantities in 3, and present in normal amounts in 4 patients. The oral administration of cholic acid, 1.0 g daily for 4 days, was accompanied by a rise in biliary DC from subnormal to normal levels in 3 patients, but had little or no effect in the 3 whose bile initially contained no DC. The feeding of conjugated DC, 0.4 g daily for 4 days, to 2 of the latter patients resulted in the prompt appearance of DC in bile. We conclude that both relative lack of substrate (cholic acid) and deficient intestinal conversion of cholic acid to DC may contribute to the reductions in biliary DC observed, in some patients with alcoholic cirrhosis.