Serum bile acid concentration may be elevated in the following conditions:
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*[[Portosystemic Shunt]] or [[Hepatic Microvascular Dysplasia]], in which the portal blood is directed into the systemic circulation, disrupting the enterohepatic circulation.
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*[[Small Intestinal Bacterial Overgrowth and Antibiotic Responsive Diarrhoea]] due to deconjugation of bile acids by intestinal bacteria.
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Bile acids may not reach the intestine if the biliary tract is [[Biliary Tract - Obstruction|obstructed]] or [[Biliary Tract - Rupture|ruptured]]. Deficiency of bile acids is extremely rare, even with severe hepatic insufficiency.