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Related Experiment Videos

Postinfective diarrhoea and bile acid malabsorption

S K Niaz1, K Sandrasegaran, F H Renny

  • 1Russells Hall Hospital, Dudley.

Journal of the Royal College of Physicians of London
|January 1, 1997
PubMed
Summary

Postinfective chronic diarrhea is often linked to bile acid malabsorption. Bile acid sequestrants effectively treat this condition, significantly reducing stool frequency in patients.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Internal Medicine

Background:

  • Postinfectious irritable bowel syndrome (IBS) and idiopathic bile acid malabsorption (BAM) present diagnostic challenges.
  • Bile acid malabsorption is a known cause of chronic diarrhea, but its postinfectious origin is not well understood.

Purpose of the Study:

  • To investigate the link between acute gastroenteritis and chronic bile acid malabsorption.
  • To evaluate the efficacy of bile acid sequestrants in treating postinfective diarrhea associated with BAM.

Main Methods:

  • Retrospective analysis of 84 patients with confirmed bile acid malabsorption (BMAM) via 75SeHCAT scans (<15% retention).
  • Identified causes of BMAM including ileal surgery, Crohn's disease, radiation enteritis, and post-gastrointestinal surgery.
  • Assessed history of acute gastroenteritis in patients with apparently idiopathic BMAM.
  • Measured changes in stool frequency before and after treatment with bile acid sequestrants.

Main Results:

  • Of 29 patients with idiopathic BMAM, 16 reported a history of acute gastroenteritis preceding chronic diarrhea.
  • Common causes of BMAM included Crohn's disease (22), radiation enteritis (13), and post-surgical changes (10).
  • Treatment with bile acid sequestrants reduced mean daily stool frequency from 7.2 to 2.1 (p < 0.001).

Conclusions:

  • Postinfective chronic diarrhea is frequently associated with bile acid malabsorption.
  • Bile acid malabsorption, even when seemingly idiopathic, may stem from prior infections.
  • Bile acid sequestrants, such as cholestyramine, offer an effective treatment for this condition.

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