Fecal bile acids and cholesterol metabolites of patients with ulcerative colitis, a high-risk group for development of colon cancer.

Patients with chronic ulcerative colitis are at increased risk of developing carcinoma of the colon. It has been shown that the concentration of fecal bile acids and neutral sterols was higher in cancer patients than in the comparable healthy controls. Fecal neutral steroids and bile acids were measured in patients with ulcerative colitis, family controls who were immediate relatives of patients, patients with other digestive diseases, and healthy unrelated controls. The fecal excretion of cholesterol, coprostanol, and cholestane-3beta, 5alpha, 6beta-triol was higher in patients with ulcerative colitis than in other groups. Patients with other diseases, family controls, and unrelated controls excreted comparable levels of neutral sterols. Patients with ulcerative colitis excreted levels of bile acids in their feces comparable to those excreted by other groups. These findings suggest that possible interactions between cholesterol metabolites and colonic epithelial cells may be relevant in colon carcinogenesis.