[Causes and clinical diagnosis of chologenic diarrhea]

Among the numerous differential diagnoses of chronic diarrhea, chologenic diarrhea is rarely taken into account. However, diseases or postoperative syndromes leading to bile acid malabsorption and thus resulting in chologenic diarrhea such as Crohn's disease or ileal resections have increased considerably. Further, malabsorption of bile acids might be incriminated in the pathogenesis or sequels of other digestive diseases (e.g. irritable bowel syndrome or chronic pancreatitis) and also can be the only characteristic in the rare "idiopathic" bile acid malabsorption. Etiologies, pathophysiology and the clinical sequels of impaired bile acid absorption have been elucidated in recent years, but in clinical medicine several questions remained unresolved since valid and generally acceptable analytical methods for the detection of bile acid malabsorption have not been developed until recently. In this field, radioisotope methods have considerably expanded our diagnostic facilities.