Bile Acid Malabsorption
Bile acids are made in the liver, travel to the gallbladder, are released into the small intestine.
They help digest fats and are re‑absorbed in the ileum.
This process is called the enterohepatic circulation.
They help digest fats and are re‑absorbed in the ileum.
This process is called the enterohepatic circulation.
When the ileum is damaged, bile acids are not re‑absorbed.
Passing into the colon.
Causing watery diarrhea.
It can also cause abdominal pain.
This condition is called bile acid malabsorption (BAM).
Passing into the colon.
Causing watery diarrhea.
It can also cause abdominal pain.
This condition is called bile acid malabsorption (BAM).
Causes
Crohn’s disease can damage the ileum.
Surgical removal of part of the ileum can lead to BAM.
Radiation therapy can scar the ileum.
Some infections can affect ileal function.
Certain drugs, like cholestyramine, can alter bile flow.
Surgical removal of part of the ileum can lead to BAM.
Radiation therapy can scar the ileum.
Some infections can affect ileal function.
Certain drugs, like cholestyramine, can alter bile flow.
Symptoms
Frequent, loose stools.
Urgency to go to the bathroom.
Fats in the stool, which may be oily.
Abdominal cramping.
Weight loss in severe cases.
Urgency to go to the bathroom.
Fats in the stool, which may be oily.
Abdominal cramping.
Weight loss in severe cases.
Diagnosis
Stool test can measure bile acids.
48‑hour SeHCAT scan is common.
Blood tests may show low vitamin B12.
Doctors may also check for other causes of diarrhea.
48‑hour SeHCAT scan is common.
Blood tests may show low vitamin B12.
Doctors may also check for other causes of diarrhea.
Treatment
Bile acid sequestrants bind excess bile.
Cholestyramine is often first‑line.
Cholestyramine is often first‑line.
Low‑fat diet can reduce symptoms.
Vitamin B12 supplements may be needed.
Probiotics are sometimes tried.
Vitamin B12 supplements may be needed.
Probiotics are sometimes tried.