Bile acid malabsorption

Bile acid diarrhea / Bile acid malabsorption
Other namesBile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea, bile salt malabsorption
SpecialtyGastroenterology
SymptomsBowel movement frequency, soft or watery stools, diarrhea, urgency[1]
ComplicationsAnxiety, fecal incontinence
Usual onsetAny age
DurationChronic (longlasting, persistent)
TypesPrimary or secondary or types 1, 2 and 3
CausesSurgical resection of ileum, cholecystectomy, idiopathic
Risk factorsPelvic radiation disease, small intestinal bacterial overgrowth
Diagnostic methodFecal bile acids, SeHCAT, 7α-hydroxy-4-cholesten-3-one
Differential diagnosisIrritable bowel syndrome, microscopic colitis
MedicationBile acid sequestrants
PrognosisGood with treatment
Frequency1 in 100 of population
DeathsNon-fatal

Bile acid malabsorption (BAM), known also as bile acid diarrhea, is a cause of several gut-related problems, the main one being chronic diarrhea. It has also been called bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea or bile salt malabsorption. It can result from malabsorption secondary to gastrointestinal disease, or be a primary disorder, associated with excessive bile acid production. Treatment with bile acid sequestrants is often effective. It is recognised as a disability in the United Kingdom under the Equality Act 2010.

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