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Related Experiment Videos

Bile acid malabsorption in persistent diarrhoea.

M J Smith1, P Cherian, G S Raju

  • 1Department of Gastroenterology, Rotherham General Hospitals NHS Trust.

Journal of the Royal College of Physicians of London
|November 15, 2000
PubMed
Summary

Bile acid malabsorption (BAM) is common in chronic diarrhoea, especially in irritable bowel syndrome (IBS). Bile acid sequestrants (BAS) effectively treat BAM when conventional therapies fail.

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Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Digestive Diseases

Background:

  • Chronic diarrhoea affects a significant patient population.
  • Bile acid malabsorption (BAM) is a recognized cause of chronic diarrhoea.
  • Investigating BAM prevalence and treatment response is crucial for patient management.

Purpose of the Study:

  • To determine the prevalence of bile acid malabsorption (BAM) in patients with chronic diarrhoea.
  • To evaluate the effectiveness of different treatment strategies for BAM.
  • To assess BAM in specific patient groups including Crohn's disease and irritable bowel syndrome (IBS).

Main Methods:

  • Utilized 7-day 75-SeHCAT retention test to diagnose BAM (normal >10%).
  • Categorized 304 patients into four groups: Crohn's disease (ileal resection/unoperated), post-gastric surgery, and IBS.

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  • Assessed treatment response based on patient-reported sustained improvement after conventional therapy or bile acid sequestrants (BAS).

    • Main Results:

    • BAM prevalence was high: 97% in Crohn's with ileal resection, 54% in unoperated Crohn's, 58% in gastric surgery patients, and 33% in IBS patients.
    • Bile acid sequestrants (BAS) showed higher response rates than conventional therapy across all groups, particularly in IBS (70% vs. 15%) and post-gastric surgery patients (64% vs. 18%).
    • Conventional therapies were less effective, with response rates ranging from 15% to 55% depending on the patient group.

    Conclusions:

    • Bile acid malabsorption (BAM) is a frequent finding in patients presenting with chronic diarrhoea, including those diagnosed with irritable bowel syndrome (IBS).
    • Bile acid sequestrants (BAS) represent an effective treatment option for BAM when initial therapies like antidiarrhoeal drugs prove insufficient.
    • These findings support the consideration of BAM testing and BAS treatment in chronic diarrhoea management, especially in IBS and post-surgical cases.