Diarrhea

Bile Acid Malabsorption

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Bile Acid Malabsorption

  • Pathophysiology
  1. Terminal ileum fails to reabsorb bile acids
  2. Results in Secretory Diarrhea (Chronic Watery Diarrhea)
  • Associated Conditions
  1. Irritable Bowel Syndrome
    1. One third malabsorb bile acids
  2. Microscopic Colitis
    1. One third malabsorb bile acids
  3. Crohn Disease Diarrhea
  4. Post-CholecystectomyDiarrhea
  • Labs
  • Experimental
  1. Serum 7a-hydroxy-4-cholesten-3-one
    1. Increased in Bile Acid Malabsorption
  2. Fibroblast growth factor 19
    1. Decreased in Bile Acid Malabsorption
  • Imaging
  • Not available in U.S.
  1. Selenium homocholic acid taurocholate scanning (SeHCAT)
    1. Radionuclide tracer used in whole body gamma imaging (Not FDA approved in U.S.)
  • Management