Systematic review: the management of chronic diarrhoea due to bile acid malabsorption

2014 ◽  
Vol 39 (9) ◽  
pp. 923-939 ◽  
Author(s):  
C. Wilcox ◽  
J. Turner ◽  
J. Green
Keyword(s):  
Systematic Review ◽  
Bile Acid ◽  
Chronic Diarrhoea ◽  
Bile Acid Malabsorption

scholarly journals Letter: bile acid malabsorption - what is the prevalence in patients with chronic diarrhoea?

2014 ◽  
Vol 40 (2) ◽  
pp. 215-215 ◽  
Author(s):  
M. Kurien ◽  
S. Chaudhary ◽  
J. R. McConnell ◽  
J. S. Leeds ◽  
D. S. Sanders
Keyword(s):  
Bile Acid ◽  
Chronic Diarrhoea ◽  
Bile Acid Malabsorption

scholarly journals Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

2019 ◽  
Author(s):  
Ivan Aleksandrov Lyutakov ◽  
Francesco Ursini ◽  
Plamen Ivanov Penchev ◽  
Giacomo Caio ◽  
Antonio Carroccio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bile Acid ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Diagnostic Yield ◽  
Standard Test ◽  
Diagnostic Methods ◽  
Fasting Serum ◽  
Bile Acid Malabsorption ◽  
Manual Search

Abstract Background Bile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.Objective We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking.Design A PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.Results Overall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.Conclusions Our systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

Impact of bile acid malabsorption on steatorrhoea and symptoms in patients with chronic diarrhoea

2000 ◽  
Vol 12 (5) ◽  
pp. 541-548 ◽  
Author(s):  
Kjell-Arne Ung ◽  
Anders F. Kilander ◽  
Anders Lindgren ◽  
Hasse Abrahamsson
Keyword(s):  
Bile Acid ◽  
Chronic Diarrhoea ◽  
Bile Acid Malabsorption

Bile Acid Malabsorption in Patients with Chronic Diarrhoea: Clinical Value of SeHCAT Test

2003 ◽  
Vol 38 (8) ◽  
pp. 826-830 ◽  
Author(s):  
Wildt S. ◽  
S. Nørby Rasmussen ◽  
J. Lysgård Madsen ◽  
Rumessen J. J.
Keyword(s):  
Bile Acid ◽  
Chronic Diarrhoea ◽  
Clinical Value ◽  
Bile Acid Malabsorption

scholarly journals Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

2019 ◽  
Author(s):  
Ivan Aleksandrov Lyutakov ◽  
Francesco Ursini ◽  
Plamen Ivanov Penchev ◽  
Giacomo Caio ◽  
Antonio Carroccio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bile Acid ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Diagnostic Yield ◽  
Diagnostic Methods ◽  
Fasting Serum ◽  
Bile Acid Malabsorption ◽  
Manual Search ◽  
Objective Detection

Abstract BackgroundBile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.ObjectiveTo perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with bile acid malabsorption.DesignA PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.ResultsOverall, more than one tests was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.ConclusionsOur systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

scholarly journals Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

2019 ◽  
Author(s):  
Ivan Aleksandrov Lyutakov ◽  
Francesco Ursini ◽  
Plamen Ivanov Penchev ◽  
Giacomo Caio ◽  
Antonio Carroccio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bile Acid ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Diagnostic Yield ◽  
Standard Test ◽  
Diagnostic Methods ◽  
Fasting Serum ◽  
Bile Acid Malabsorption ◽  
Manual Search

Abstract Background Bile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.Objective We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking.Design A PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.Results Overall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.Conclusions Our systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

scholarly journals Methods for diagnosing bile acid malabsorption: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ivan Lyutakov ◽  
Francesco Ursini ◽  
Plamen Penchev ◽  
Giacomo Caio ◽  
Antonio Carroccio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bile Acid ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Diagnostic Yield ◽  
Standard Test ◽  
Diagnostic Methods ◽  
Fasting Serum ◽  
Bile Acid Malabsorption ◽  
Manual Search

Abstract Background Bile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests. We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking. Methods A PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test. Results Overall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n = 8 studies used 75Selenium-homotaurocholic-acid-test (75SeHCAT) with a < 10% retention threshold; n = 8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n = 3 studies involved total fecal bile acid (BA) excretion over 48 h; n = 4 studies assessed fibroblast growth factor 19 (FGF19). 75SeHCAT showed an average sensitivity and specificity of 87.32 and 93.2%, respectively, followed by serum C4 (85.2 and 71.1%) and total fecal BA (66.6 and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8 and 72.3%). All the extracted data were associated with substantial heterogeneity. Conclusions Our systematic review indicates that 75SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

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