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Related Experiment Video

Updated: Jul 8, 2025

Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport
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Using Multi-fluorinated Bile Acids and In Vivo Magnetic Resonance Imaging to Measure Bile Acid Transport

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Recent developments in diagnosing bile acid diarrhea.

Camille Lupianez-Merly1, Saam Dilmaghani1, Michael Camilleri1

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Rochester, MN, USA.

Expert Review of Gastroenterology & Hepatology
|December 12, 2023
PubMed
Summary
This summary is machine-generated.

Bile acid diarrhea (BAD) causes chronic diarrhea, often misdiagnosed. New noninvasive stool and serum tests offer accurate diagnosis, improving patient care and reducing healthcare costs.

Keywords:
7αC4FGF-19SeHCATSequestrantschronic diarrheadiarrhea-predominant irritable bowel syndromeinflammatory bowel diseasemalabsorption

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Area of Science:

  • Gastroenterology
  • Digestive Diseases
  • Clinical Diagnostics

Background:

  • Bile acid diarrhea (BAD) is a common cause of chronic diarrhea, frequently misdiagnosed as functional gut disorders.
  • Delayed diagnosis of BAD increases healthcare burden and diminishes patient quality of life due to lack of accessible diagnostic tools.

Purpose of the Study:

  • To review and discuss available diagnostic modalities for Bile Acid Diarrhea (BAD).
  • To highlight noninvasive stool and serum tests for accurate and timely BAD diagnosis.

Main Methods:

  • A literature review was performed using PubMed, focusing on bile acid biology, BAD pathophysiology, and diagnostic testing.
  • Reviewed diagnostic tests include 75SeHCAT retention, 7αC4, FGF-19, fecal bile acids, and single stool tests.

Main Results:

  • Noninvasive stool and serum tests demonstrate good sensitivity and specificity for diagnosing BAD.
  • Alternative tests include fecal bile acid excretion (48-hour or single stool), serum 7αC4 levels, and combinations thereof.

Conclusions:

  • Clinical practice should prioritize definitive diagnosis of BAD using readily available noninvasive tests.
  • BAD should be considered in the differential diagnosis of various gastrointestinal conditions.