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

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 TP1.2.1SeHCAT scan as an investigation for chronic diarrhoea; a single trust experience

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Marwa Al-Azzawi ◽  
Sally Darnborough ◽  
Lynsey Devlin ◽  
Sai Han ◽  
Alison Bolster ◽  
...  
Keyword(s):  
Bile Acid ◽  
British Society ◽  
Symptom Improvement ◽  
Chronic Diarrhoea ◽  
Duration Of Symptoms ◽  
Bile Acid Sequestrants ◽  
Bile Acid Malabsorption ◽  
Included Patient ◽  
Patients At Risk ◽  
Type 3

Abstract Introduction:  Recent published (British Society of Gastroenterology) guidelines strongly recommended investigating unexplained chronic loose stools with  SeHCAT  scans when available rather than empirical treatment.  SeHCAT  scan was  introduced  at our trust in 2015. We aimed to audit this locally.   Methods  All  SeHCAT  scans that were done at our trust trust from Jan 2015 to March 2020  were included. Patient demographics along with risk factors and duration of symptoms were documented as well as the referred speciality.   Results   55 patients were identified. Average age at time of diagnosis was 50y (18-70y).  M:F  was 1:3.2 . Most scans were requested by the oncology team as part of the “pelvic radiotherapy late effects service” (n = 25), followed by the gastroenterology team (n = 22) and general surgery team (n = 8). The mean duration of symptoms was 4 years. 73% of the scans showed evidence of bile acid malabsorption (BAM)  (n = 40) with bile retention <15%, with the majority of them (n = 30) having severe BAM (retention <5%).  60% of the patients had at least one lower GI endoscopy as part of their workup. The majority of patients were found to have type 3 BAM (n = 37).   60% of patients had symptom improvement on either diet alone or with bile-acid sequestrants (n = 23) and were discharged. Conclusion:  SeHCAT scan is a useful test to investigate unexplained chronic diarrhoea. It is important to identify patients at risk of developing bile acid malabsorption. It is currently underutilized by our trust, which might be because of funding issues and awareness among clinicians.

scholarly journals Biliary lipid composition in idiopathic bile acid malabsorption

Gut ◽  
1998 ◽  
Vol 43 (6) ◽  
pp. 812-816 ◽  
Author(s):  
M Fracchia ◽  
S Pellegrino ◽  
P Secreto ◽  
A Pera ◽  
G Galatola
Keyword(s):  
Bile Acid ◽  
Bile Acids ◽  
Lipid Composition ◽  
Chronic Diarrhoea ◽  
Biliary Lipid ◽  
Bile Acid Pool ◽  
Acid Pool ◽  
Bile Acid Malabsorption ◽  
Increased Risk ◽  
Biliary Lipid Composition

Background—Chronic diarrhoea is the clinical hallmark of patients presenting with idiopathic bile acid malabsorption. Its pathogenesis is unknown; colonic water secretion can be induced by dihydroxy bile acids, but it is not known whether enrichment of the bile acid pool with these bile acids occurs in such patients. Furthermore, bile acid malabsorption is known to affect biliary lipid composition, but no information is available for the idiopathic type.Aims—To verify: (a) whether diarrhoea in patients with idiopathic bile acid malabsorption is associated with enrichment of the bile acid pool with dihydroxy bile acids; and (b) whether supersaturation with cholesterol of duodenal bile occurs in such patients as a result of chronic bile acid depletion.Patients—Thirteen patients with idiopathic bile acid malabsorption diagnosed according to abnormal 75SeHCAT test and absence of other organic diseases, and 23 control subjects.Methods—Bile rich duodenal fluid was collected during intravenous ceruletide infusion in the fasting state. Biliary lipids were analysed by enzymatic assays and bile acids by high performance liquid chromatography.Results—Patients with idiopathic bile acid malabsorption had a cholesterol saturation index similar to controls. Bile acid composition showed only a decrease in percentage cholic acid (29 (2)% versus 36 (2)%; p<0.05); the dihydroxy:trihydroxy bile acid ratio was similar to controls.Conclusions—Patients with idiopathic bile acid malabsorption do not have an increased risk of forming cholesterol gallstones. The mechanism of diarrhoea does not seem to depend on an enrichment of the bile acid pool with dihydroxy bile acids.

scholarly journals Measurement of serum 7α-hydroxy-4-cholesten-3-one as a marker of bile acid malabsorption in dogs with chronic diarrhoea: a pilot study

2016 ◽  
Vol 3 (1) ◽  
pp. e000163 ◽  
Author(s):  
A. C. C. Kent ◽  
G. Cross ◽  
D. R. Taylor ◽  
R. A. Sherwood ◽  
P. J. Watson
Keyword(s):  
Bile Acid ◽  
Pilot Study ◽  
Chronic Diarrhoea ◽  
Bile Acid Malabsorption

PTH-230 Increased prevalence of bile acid malabsorption in patients with breast cancer and chronic diarrhoea

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A511.2-A511 ◽  
Author(s):  
K Klimova ◽  
A Lalji ◽  
A Muls ◽  
J Andreyev
Keyword(s):  
Breast Cancer ◽  
Bile Acid ◽  
Chronic Diarrhoea ◽  
Bile Acid Malabsorption

scholarly journals Prevalence of biliary acid malabsorption in patients with chronic diarrhoea of functional characteristics: a prospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Virginia Flores ◽  
Helena Martínez-Lozano ◽  
Federico Bighelli ◽  
Javier Orcajo ◽  
Javier García-Lledó ◽  
...  
Keyword(s):  
Bile Acid ◽  
Clinical Response ◽  
Significant Proportion ◽  
Unknown Origin ◽  
Systematic Investigation ◽  
Watery Diarrhoea ◽  
Chronic Diarrhoea ◽  
Functional Characteristics ◽  
Bile Acid Malabsorption ◽  
Rule Out

Abstract Background Bile acid malabsorption occurs in up to one third of patients with chronic diarrhoea of functional characteristics. The gold standard test for its diagnosis is the 75Selenium homocholic acid taurine (75SeHCAT) test. The aim of this work is to confirm previous data suggesting that bile acid malabsorption, diagnosed by 75Se-HCAT test, is the underlying cause of diarrhoea in a significant proportion of patients previously diagnosed with a functional disorder. In addition, we have analysed the clinical response of bile acid sequestrants in those patients with a bile acid diarrhoea diagnosis. Methods This is a prospective, single-centre study including consecutive adult patients diagnosed with chronic diarrhoea of unknown origin and with functional characteristics; systematic rule out of common causes of chronic diarrhoea was performed before bile acid malabsorption evaluation by 75SeHCAT scanning. A retention percentage less than 10% was considered positive. Clinical response to cholestyramine was further evaluated in those patients with a positive diagnosis of bile acid diarrhoea Results 38 patients (20 male, mean age 37.5 years) were finally included. Twenty (52.6%) patients included had a positive 75SeHCAT test. Median body mass index was significantly higher in those patients. We did not find significant differences in other clinical or biochemical variables 75SeHCAT-positive and 75SeHCAT-negative groups. Only 6 of 17 (35.3%) patients responded to cholestyramine treatment; 10 patients did not have response or withdraw the drug due to adverse events. Logistic regression analysis showed that none of the included variables was a predictor of clinical response to cholestyramine. Conclusions Bile acid malabsorption occurs in a high proportion of patients suffering from chronic diarrhoea with functional characteristics. Systematic investigation of bile acid malabsorption should be included in the diagnostic algorithms of patients with chronic watery diarrhoea in the routine clinical practice. Absence of response to cholestyramine does not rule out bile acid diarrhoea.

Sign in / Sign up

Export Citation Format

Share Document