Q: How can one measure increased concentration of bile acids/salts in blood?I am suffering from muliple bile stones and my doctor suspected that intense itching could be due to high level of bile acid concentration in blood. What is the significance of this test? What is the cost? Which other tests can be done to confirm that itching is either because of bile acids or any other hepato- billiary disease? My second query is that what happens if gall bladder is removed?

A:1. Bile acids/salts can be measured in the blood but these tests do not provide much useful information. Therefore, these tests are not commonly performed. 2. The important thing is to find out whether you have stones in the bile duct. If you do indeed have stones, these should be removed either by endoscopy or surgery. 3. There is no harm in removing the gallbladder. In fact, a diseased gallbladder should be removed without delay otherwise it can lead to more complications.