Bile Acid Malabsorption (BAM) resulting from bile acid overproduction or reduced transport can increase fecal bile acids and cause chronic diarrhea. BAM is thought to account for up to 30% of patients diagnosed with irritable bowel syndrome (IBS-D). Current methods of diagnosing BAM are limited; it is likely under-diagnosed. Our objective was to develop a non-invasive method of detecting BAM by synthesizing and testing a multi-fluorinated bile acid (MFBA) that can be used for fluorine magnetic resonance imaging (MRI) of bile acid enterohepatic circulation. A prototype MFBA was synthesized by conjugating trifluoroacetyl lysine to cholic acid (19F-CA-lys). This MFBA was tested for transport and inhibition of the apical sodium dependent bile acid transporter (ASBT) using stably transfected MDCK cell monolayers and of Na+/taurocholate cotransporting polypeptide (NTCP) using stably transfected HEK cell monolayers. In Vitro, 19F-CA-lys was a potent inhibitor and substrate of both ASBT (Ki = 20.0±3.9 μM, Kt = 39.4±23.8 μM, normalized Vmax =0.853 ± 0.197) and NTCP (Ki = 2.93±0.60 μM, Kt = 8.99 ± 2.79 μM, normalized Vmax = 0.281±0.052). Stability of 19F-CA-lys (5 μM) was measured after treatment with Caco-2 cell homogenates, rat plasma, rat liver microsomal S9 pools, simulated intestinal fluid with pancreatic enzymes, 1 M HCl, buffers at pH 7.4 and 6.8, and choloylglycine hydrolase (CGH) (N=3 for each condition). Except for CGH, 19F-CA-lys was stable in each condition. After 1 h in CGH, 60.4±4.0% 19F-CA-lys remained compared to 2.4±0.5% naturally-occurring taurocholic acid (P<0.005). To test In Vivo stability and utility of 19F-CA-lys for MRI, we examined its distribution in 8 male C57BL/6 mice (average weight, 25.7 g). After overnight fasting, mice were gavaged with 1:1 polyethylene glycol (PEG):water vehicle control (2 mice), 150 mg/ kg 19F-CA-lys (3 mice) and 300 mg/kg 19F-CA-lys (3 mice). Four hours after dosing, 19FCA-lys in gallbladder, liver and plasma was measured by LC/MS. 19F-CA-lys was not detected in control mice receiving vehicle alone. With 150 and 300 mg/kg 19F-CA-lys, 4 h gallbladder 19F-CA-lys concentrations were 27.0±2.5 and 36.8±8.8 μmol/g, liver concentrations were 0.079±0.035 and 0.057±0.010 μmol/g, and plasma concentrations were 0.444±0.170 and 0.418 ± 0.015 μM, respectively. We calculated that at both doses, 10.8±1.9% (95% CI, 5.915.8%) of administered 19F-CA-lys was present in the gallbladder. We conclude that 19FCA-lys, a novel MFBA, is stable In Vitro and In Vivo, and accumulates in the gallbladder at concentrations that will provide a 19F signal in excess of that we previously determined to be the minimum detectable by 19F MRI (Drug Metab. Disp. 39:736, 2011). These findings suggest that non-radioactive MFBAs have excellent potential to measure In Vivo bile acid transport and serve as clinical imaging tools to diagnosis BAM.