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Bile Acid Malabsorption

Sanjiv chopra, MBBS. MACP and Laura C> Horton, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Bile acid malabsorption occurs when increasedprimary bile acids in the colon lead to chronic diarrhea and abdominal symptoms such as discomfort and bloating.

  • Definitions (1)

    • Type 1: ...

DIAGNOSIS

HISTORY

Diarrhea is the hallmark of bile acid malabsorption. Other associated symptoms include abdominal discomfort, bloating, and fecal urgency (1,2,3). 

PHYSICAL EXAM

No specific findings on...

TREATMENT

MEDICATION

  • Bile acid sequestrants are the mainstay of treatment and may improve abdominal symptoms and stooling.

  • 70-96% patients with chronic diarrhea from bile acid malabsorption respond to ...

ONGOING CARE

In patients with bile acid malabsorption due to IBD, treatment of IBD may improve malabsorption symptoms. 

FOLLOW-UP RECOMMENDATIONS

No specific follow-up recommendations. 

Patient Monitoring

REFERENCES

1
Camilleri M, Vijayvargiya P. The Role of Bile Acids in Chronic Diarrhea. Am J Gastroenterol. 2020 Oct;115(10):1596-1603.
2
Johnston I, Nolan J, Pattni SS, Walters JR. New insights into bile ...

CLINICAL PEARLS

  • Suspect bile acid malabsorption in patients with diarrhea who also complain of abdominal discomfort, bloating, and fecal urgency.       

  • Consider empiric treatment with a short course o...

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