Bile acid diarrhea

Perhaps the greatest need is for increased recognition of the role of BA in the generation of the symptoms of chronic diarrhoea, urgency, incontinence, bloating and discomfort in what would have been labelled as IBS-D or as functional diarrhoea.

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Bile acid malabsorption is common in Crohn's disease but not always recognised. Most patients with previous ileal resection and chronic diarrhea will have abnormal SeHCAT tests and can benefit from bile acid sequestrants.

Patients with primary bile acid diarrhea are frequently misdiagnosed as having the irritable bowel syndrome as clinicians fail to recognize the condition. When SeHCAT testing is performed, the diagnosis of primary bile acid diarrhea is commonly made. In a review of 18 studies of the use of SeHCAT testing in diarrhea-predominant irritable bowel syndrome patients, 32% of 1223 patients had a SeHCAT 7-day retention of less than 10%, and 80% of these reported a response to cholestyramine, a bile acid sequestrant.

Estimates of the population prevalence taken from this review suggest that 1% of the adult population could have primary bile acid diarrhea (Type 2 bile acid malabsorption).

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jb116 said:

post 103759 it's a curious thing however, these sequestrants. Because they will lower cholesterol which isn't a desirable effect.

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