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Bile acid malabsorption

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604:. When SeHCAT testing is performed, the diagnosis of primary bile acid diarrhea is commonly made. In a review of 18 studies of the use of SeHCAT testing in diarrhea-predominant irritable bowel syndrome patients, 32% of 1223 people had a SeHCAT 7-day retention of less than 10%, and 80% of these reported a response to cholestyramine, a bile acid sequestrant. 1974:
Camilleri M, Nord SL, Burton D, Oduyebo I, Zhang Y, Chen J, Im K, Bhad P, Badman MK, Sanders DS, Walters JR (September 2020). "Randomised clinical trial: significant biochemical and colonic transit effects of the farnesoid X receptor agonist tropifexor in patients with primary bile acid diarrhoea".
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A study from 2023 investigating the epidemiology of bile acid diarrhea in Denmark, found that people suffering from bile acid diarrhea seemed to have more co-morbidities, lower levels of income and education and more health care contacts compared with matches not suffering from bile acid diarrhea.
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had unexpected effects in clinical cases with co-existing bile acid diarrhoea which led to a randomised, double-blind, active-comparator, non-inferiority clinical trial. This trial demonstrated superiority in favour of liraglutide compared with colesevelam in reducing stool frequency and improved
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Primary bile acid diarrhea (Type 2 bile acid "malabsorption") may be caused by an overproduction of bile acids. Several groups of workers have failed to show any defect in ileal bile acid absorption in these patients, and they have an enlarged bile acid pool, rather than the reduced pool expected
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test involves two scans a week apart and so measures multiple cycles of bile acid excretion and reabsorption. There is limited radiation exposure (0.3 mSv). Retention of SeHCAT at 7 days is normally above 15%; values less than 15%, 10% and 5% predict respectively mild, moderate and severe
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A study found that patients suffering from bile acid diarrhea are characterized by a dysmetabolic and prediabetic-like profile, with higher postprandial concentrations of glucose, insulin and glucagon, compared with matched healthy controls. The underlying mechanisms are not fully understood.
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Kårhus ML, Brønden A, Forman JL, Haaber A, Knudsen E, Langholz E, Dragsted LO, Hansen SH, Krakauer M, Vilsbøll T, Sonne DP, Knop FK (October 2022). "Safety and efficacy of liraglutide versus colesevelam for the treatment of bile acid diarrhoea: a randomised, double-blind, active-comparator,
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Borup C, Vinter-Jensen L, Jørgensen SP, Wildt S, Graff J, Gregersen T, Zaremba A, Borup Andersen T, Nøjgaard C, Timm HB, Rainteau D, Hansen SH, Rumessen JJ, Munck LK (April 2023). "Efficacy and safety of colesevelam for the treatment of bile acid diarrhoea: a double-blind, randomised,
424:, absorption is less efficient (Type 3 bile acid malabsorption). A very small proportion of the patients with no obvious disease (Type 2 bile acid malabsorption) may have mutations in ASBT, but this mutation is not more common in most patients and does not affect function. 416:. These bile acid transporters are all highly expressed in the ileum but not in the liver, jejunum or colon. When expression of these specialized transporters is reduced, the intestine is less efficient at bile acid reabsorption (Type 1 bile acid malabsorption). If 481:
The various biomarkers give similar diagnostic yields of around 25% in patients with functional bowel disorders with diarrhea. In countries such as the US, where SeHCAT is not available, fecal bile acids and C4 are available to make the diagnosis.
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Wedlake, L; Thomas, K; Lalji, A; Anagnostopoulos, C; Andreyev, HJ (2009). "Effectiveness and tolerability of colesevelam hydrochloride for bile-acid malabsorption in patients with cancer: a retrospective chart review and patient questionnaire".
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Valentin, N; Camilleri, M; Altayar, O; Vijayvargiya, P; Acosta, A; Nelson, AD; Murad, MH (December 2016). "Biomarkers for bile acid diarrhoea in functional bowel disorder with diarrhoea: a systematic review and meta-analysis".
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Bile acid malabsorption is common in Crohn's disease but not always recognized. Most people with previous ileal resection and chronic diarrhea will have abnormal SeHCAT tests and can benefit from bile acid sequestrants.
556:, both in powder form, have been used for many years. Unfortunately, many patients find them difficult to tolerate; although the diarrhea may improve, other symptoms such as abdominal pain and bloating may worsen. 961:
Montagnani, M; Love, MW; Rössel, P; Dawson, PA; Qvist, P (2001). "Absence of dysfunctional ileal sodium-bile acid cotransporter gene mutations in patients with adult-onset idiopathic bile acid malabsorption".
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Brydon, WG; Nyhlin, H; Eastwood, MA; Merrick, MV (1996). "Serum 7 alpha-hydroxy-4-cholesten-3-one and selenohomocholyltaurine (SeHCAT) whole body retention in the assessment of bile acid induced diarrhoea".
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Walters JR, Johnston IM, Nolan JD, Vassie C, Pruzanski ME, Shapiro DA (January 2015). "The response of patients with bile acid diarrhoea to the farnesoid X receptor agonist obeticholic acid".
474:, (C4), a bile acid precursor, in serum, shows the increased bile acid synthesis found in bile acid malabsorption. This test is an alternative diagnostic means when available. Fasting blood 467:. This test is not licensed in the USA, and is underutilized even where it is available. Older methods such as the C-glycocholic breath test are no longer in routine clinical use. 2010:
Kårhus, M L; Brønden, A; Røder, M E (Aug 2019). "Remission of Bile Acid Malabsorption Symptoms Following Treatment With the Glucagon-Like Peptide 1 Receptor Agonist Liraglutide".
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Several methods have been developed to identify the disorder but there are difficulties with all of them. Diagnosis of bile acid malabsorption is easily and reliably made by the
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Ellegaard AM, KĂĄrhus ML, Winther-Jensen M, Knop FK, KĂĄrhus LL (May 2024). "Bile Acid Diarrhea Is Associated With an Increased Incidence of Gastrointestinal Cancers".
1846:"Colesevelam for the treatment of bile acid malabsorption-associated diarrhea in patients with Crohn's disease: A randomized, double-blind, placebo-controlled study" 217:. It has also been called bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea or bile salt malabsorption. It can result from 2372: 588:
pathophysiological markers, suggesting it may be a new, safe and more effective treatment compared with current established, cheaper treatment modalities.
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van Tilburg, AJ; de Rooij, FW; van den Berg, JW; van Blankenstein, M (1992). "Primary bile acid malabsorption: a pathophysiologic and clinical entity?".
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Estimates of the population prevalence suggest that 1% of the adult population could have primary bile acid diarrhea (Type 2 bile acid malabsorption).
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with malabsorption. The synthesis of bile acids in the liver is negatively regulated by the ileal hormone fibroblast growth factor 19 (
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is a tablet which is well tolerated and has been shown in placebo-controlled, randomized clinical trials to be effective.
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Beigel F, Teich N, Howaldt S, Lammert F, Maul J, Breiteneicher S, Rust C, Göke B, Brand S, Ochsenkühn T (November 2014).
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is another farnesoid X receptor agonist that has been studied, showing improvements in biochemistry and colonic transit.
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Sadowski, DC; Camilleri, M; Chey, WD; Leontiadis, GI; Marshall, JK; Shaffer, EA; Tse, F; Walters, JRF (January 2020).
437:), and lower levels of this hormone result in overproduction of bile acids, which are more than the ileum can absorb. 2340: 2810: 2739: 3083: 3039: 2992: 2798: 2416: 509: 349: 3109: 1129:"Enterohepatic, Gluco-metabolic, and Gut Microbial Characterization of Individuals With Bile Acid Malabsorption" 1086:"Enterohepatic, Gluco-metabolic, and Gut Microbial Characterization of Individuals With Bile Acid Malabsorption" 3429: 2744: 2702: 2515: 2390: 2377: 2318: 2223: 601: 446:
Furthermore, gut microbiome composition differs from that of people who do not suffer from bile acid diarrhea.
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Walters, JR (2010). "Defining primary bile acid diarrhea: making the diagnosis and recognizing the disorder".
1172:"The pathophysiology of bile acid diarrhoea: differences in the colonic microbiome, metabolome and bile acids" 768:"Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea" 720:
Vijayvargiya P, Camilleri M (March 2018). "Update on Bile Acid Malabsorption: Finally Ready for Prime Time?".
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of bile acids takes place four–six times in 24 hours and usually less than 0.5 g of bile acids enter the
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Bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea, bile salt malabsorption
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Pattni SS, Brydon WG, Dew T, Johnston IM, Nolan JD, Srinivas M, Basumani P, Bardhan KD, Walters JR (2013).
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is often effective. It is recognised as a disability in the United Kingdom under the Equality Act 2010.
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Type 1: Bile acid malabsorption, secondary to ileal resection, or ileal inflammation (e.g. in
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Bannaga, A; Kelman, L; O'Connor, M; Pitchford, C; Walters, JR; Arasaradnam, RP (2017).
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values may have value in the recognition of the disease and prediction of response.
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A nationwide cohort study indicates an association between bile acid diarrhea and
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transfer bile acids through and out of the cell where they eventually enter the
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Walters, JR; Tasleem, AM; Omer, O S; Brydon, WG; Dew, T; le Roux, CW (2009).
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People with primary bile acid diarrhea are frequently misdiagnosed as having
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is affected by gastro-intestinal surgery, or bile acids are deconjugated by
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Wedlake L, A'Hern R, Russell D, Thomas K, Walters JR, Andreyev HJ (2009).
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has shown clinical and biochemical benefits in a proof of concept study.
517: 405: 369: 262: 242: 214: 213:, is a cause of several gut-related problems, the main one being chronic 2174: 2931: 2697: 2601: 2573: 1272:"Methods for diagnosis of bile acid malabsorption in clinical practice" 409: 389: 385: 289: 281: 1988: 1934: 1755: 1738: 1581: 1564: 1389: 929: 838: 821: 505:
Type 2: Idiopathic bile acid malabsorption, Primary bile acid diarrhea
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about leaving home (primarily due to fear of fecal incontinence),
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Bowel movement frequency, soft or watery stools, diarrhea, urgency
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and other gastrointestinal symptoms such as abdominal swelling,
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abnormal retention and an increasing likelihood of response to
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Fromm, H; Malavolti, M (1986). "Bile acid-induced diarrhoea".
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Surgical Pathology of Non-neoplastic Gastrointestinal Diseases
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Bile acid malabsorption was first recognized in patients with
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are the main agents used to treat bile acid malabsorption.
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per 24 h. When larger amounts of bile acids enter the
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KĂĄrhus, M L; Ellegaard, A; Winther-Jensen, M (Dec 2023).
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Khalid, U; Lalji, A; Stafferton, R; Andreyev, J (2010).
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Zhang, Lizhi; Chandan, Vishal S.; Wu, Tsung-Teh (2019).
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Vijayvargiya P, Camilleri M, Shin A, Saenger A (2013).
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People with this disorder often report impairments of
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European Journal of Gastroenterology & Hepatology
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Oelkers, P; Kirby, LC; Heubi, JE; Dawson, PA (1997).
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Scandinavian Journal of Gastroenterology. Supplement
3510: 3396: 3389: 3330: 3244: 3201: 3047: 3038: 2991: 2945: 2900: 2786: 2673: 2563: 2550: 2425: 2299: 2290: 2168: 2083:"The Epidemiology of Bile Acid Diarrhea in Denmark" 348:and are taken up by the liver and resecreted. This 192: 184: 174: 162: 146: 129: 113: 101: 93: 85: 77: 67: 57: 45: 37: 32: 1378:Expert Review of Gastroenterology & Hepatology 826:Expert Review of Gastroenterology & Hepatology 1421:"Bile acid malabsorption: a forgotten diagnosis?" 1470: 1468: 1466: 1319: 1317: 1315: 815: 813: 761: 759: 637: 635: 633: 631: 384:is very efficient at absorbing the glyco- and 2267: 2048:The Lancet. Gastroenterology & Hepatology 1888:The Lancet. Gastroenterology & Hepatology 1886:placebo-controlled, phase 4 clinical trial". 390:apical sodium-dependent bile salt transporter 8: 2373:Esophagogastric junction outflow obstruction 33:Bile acid diarrhea / Bile acid malabsorption 328:and are released after meals stimulated by 3393: 3044: 2560: 2412:Esophageal intramural pseudodiverticulosis 2296: 2274: 2260: 2252: 2165: 1977:Alimentary Pharmacology & Therapeutics 29: 2108: 2098: 1942: 1861: 1754: 1678: 1629: 1580: 1446: 1371: 1369: 1341: 1295: 1246: 1205: 1195: 1154: 1144: 1111: 1101: 1025: 937: 888: 878: 837: 793: 783: 669: 659: 388:-conjugated forms of the bile salts. The 1737:Wilcox C, Turner J, Green J (May 2014). 1014:Clinical Gastroenterology and Hepatology 964:Scandinavian Journal of Gastroenterology 772:Clinical Gastroenterology and Hepatology 97:Primary or secondary or types 1, 2 and 3 627: 305:Enterohepatic circulation of bile salts 1824:"Bile acid malabsorption: colesevelam" 257:are common manifestations, often with 2640:Small intestinal bacterial overgrowth 1003: 1001: 918:The Journal of Clinical Investigation 522:small intestinal bacterial overgrowth 422:small intestinal bacterial overgrowth 404:) and the basolateral heterodimer of 360:, they stimulate water secretion and 253:, increased frequency and urgency of 124:small intestinal bacterial overgrowth 7: 861:Dawson, PA; Lan, T; Rao, A (2009). 376:Intestinal absorption of bile acids 368:, which causes symptoms of chronic 241:A persistent (chronic) history of 25: 3525:Spontaneous bacterial peritonitis 3372:Exocrine pancreatic insufficiency 2046:non-inferiority clinical trial". 1653:Thaysen, EH; Pedersen, L (1976). 89:Chronic (longlasting, persistent) 3572:Gastrointestinal tract disorders 3270:Secondary sclerosing cholangitis 1655:"Idiopathic bile acid catharsis" 1534:10.1097/00042737-199602000-00005 1343:10.1111/j.1365-2036.2009.04081.x 722:Current Gastroenterology Reports 441:Dysmetabolism and gut microbiome 2511:Gastric antral vascular ectasia 2506:Portal hypertensive gastropathy 2383:Gastroesophageal reflux disease 1801:10.1016/j.clinthera.2009.11.027 398:ileal bile acid binding protein 3265:Primary sclerosing cholangitis 3115:Hepatic veno-occlusive disease 2937:Solitary rectal ulcer syndrome 1: 3322:Sphincter of Oddi dysfunction 2142:10.14309/ajg.0000000000002859 2060:10.1016/S2468-1253(22)00198-4 1900:10.1016/S2468-1253(22)00401-0 1716:10.1016/S0300-5089(21)00739-2 1631:10.1016/S0016-5085(67)80140-9 1439:10.7861/clinmedicine.10-2-124 508:Type 3: Secondary to various 332:. They are important for the 105:Surgical resection of ileum, 3577:Steatorrhea-related diseases 3231:Postcholecystectomy syndrome 2750:Intestinal pseudoobstruction 2358:Esophageal motility disorder 2024:10.1053/j.gastro.2019.04.002 1863:10.1016/j.crohns.2014.05.009 1276:Clin. Gastroenterol. Hepatol 1248:10.1053/j.gastro.2019.11.301 1146:10.1016/j.gastha.2021.12.007 1103:10.1016/j.gastha.2021.12.007 472:7α-Hydroxy-4-cholesten-3-one 428:Overproduction of bile acids 229:production. Treatment with 141:7α-hydroxy-4-cholesten-3-one 1704:Clinics in Gastroenterology 1170:Sagar, NM (November 2020). 820:Hofmann AF (October 2009). 661:10.1136/bmjgast-2016-000116 73:Anxiety, fecal incontinence 3593: 3216:Gallstone / Cholelithiasis 2740:Functional colonic disease 2536:Zollinger–Ellison syndrome 1490:10.1136/gutjnl-2015-309889 1229:Jeffery, IB (March 2020). 1188:10.1038/s41598-020-77374-7 976:10.1080/003655201750422693 880:10.1194/jlr.R900012-JLR200 400:(IBABP, ILBP, gene symbol 2417:Acute esophageal necrosis 1288:10.1016/j.cgh.2013.04.029 1063:10.3109/00365529209096030 1027:10.1016/j.cgh.2009.04.024 867:Journal of Lipid Research 785:10.1016/j.cgh.2019.08.062 734:10.1007/s11894-018-0615-z 699:. Springer. p. 226. 648:BMJ Open Gastroenterology 510:gastrointestinal diseases 392:(ASBT, IBAT, gene symbol 350:enterohepatic circulation 2516:Gastric dumping syndrome 2391:Laryngopharyngeal reflux 2378:Diffuse esophageal spasm 1923:Aliment. Pharmacol. Ther 1822:NICE (29 October 2013). 1743:Aliment. Pharmacol. Ther 1569:Aliment. Pharmacol. Ther 1330:Aliment. Pharmacol. Ther 863:"Bile acid transporters" 616:gastrointestinal cancers 602:irritable bowel syndrome 340:of fats (lipids) in the 223:gastrointestinal disease 153:Irritable bowel syndrome 120:Pelvic radiation disease 3132:Alcoholic liver disease 2665:Bile acid malabsorption 2609:Peptic (duodenal) ulcer 203:Bile acid malabsorption 18:Bile salt malabsorption 3562:Diseases of intestines 3142:Hepatic encephalopathy 2526:Buried bumper syndrome 2457:Peptic (gastric) ulcer 2341:Mallory–Weiss syndrome 2284:human digestive system 585:GLP-1 receptor agonist 546:Bile acid sequestrants 465:bile acid sequestrants 316:) are produced in the 231:bile acid sequestrants 188:1 in 100 of population 169:Bile acid sequestrants 148:Differential diagnosis 3367:Pancreatic pseudocyst 3236:Porcelain gallbladder 2348:Zenker's diverticulum 1789:Clinical Therapeutics 1671:10.1136/gut.17.12.965 526:radiation enteropathy 3171:Hepatorenal syndrome 3110:Budd–Chiari syndrome 3067:Autoimmune hepatitis 2892:Intestinal adhesions 2650:Short bowel syndrome 2479:Functional dyspepsia 2397:Esophageal stricture 2363:Nutcracker esophagus 2100:10.2147/CLEP.S442054 1612:Hofmann, AF (1967). 567:farnesoid X receptor 534:chronic pancreatitis 320:, secreted into the 3310:Choledocholithiasis 3181:Metabolic disorders 3147:Acute liver failure 3120:Portal hypertension 3072:Alcoholic hepatitis 2915:Radiation proctitis 2834:Mesenteric ischemia 2806:Gastroenterocolitis 2635:Blind loop syndrome 2445:MĂ©nĂ©trier's disease 2353:Barrett's esophagus 1241:(4): 1016–1028.e8. 1133:Gastro Hep Advances 1127:KĂĄrhus, ML (2022). 1090:Gastro Hep Advances 1084:KĂĄrhus, ML (2022). 418:intestinal motility 362:intestinal motility 247:Bristol stool scale 180:Good with treatment 157:microscopic colitis 3485:Undefined location 3476:Grynfeltt–Lesshaft 3377:Pancreatic fistula 3360:Pancreatic abscess 3315:Biliary dyskinesia 3286:Mirizzi's syndrome 2787:Large and/or small 2467:Dieulafoy's lesion 2336:Boerhaave syndrome 2134:Am J Gastroenterol 259:fecal incontinence 249:), sometimes with 237:Signs and symptoms 211:bile acid diarrhea 135:Fecal bile acids, 3549: 3548: 3545: 3544: 3385: 3384: 2987: 2986: 2844:Bowel obstruction 2546: 2545: 2249: 2248: 1989:10.1111/apt.15967 1935:10.1111/apt.12999 1756:10.1111/apt.12684 1582:10.1111/apt.12466 1484:(12): 1951–1959. 1426:Clinical Medicine 1390:10.1586/egh.10.54 930:10.1172/JCI119355 839:10.1586/egh.09.49 706:978-3-030-15573-5 209:), known also as 200: 199: 131:Diagnostic method 27:Medical condition 16:(Redirected from 3584: 3537:Pneumoperitoneum 3394: 3304:Common bile duct 3186:Wilson's disease 3176:Peliosis hepatis 3045: 2922:Proctalgia fugax 2829:Abdominal angina 2754:Ogilvie syndrome 2703:Pseudomembranous 2561: 2521:Gastric volvulus 2486:Pyloric stenosis 2297: 2282:Diseases of the 2276: 2269: 2262: 2253: 2166: 2154: 2153: 2129: 2123: 2122: 2112: 2102: 2078: 2072: 2071: 2042: 2036: 2035: 2012:Gastroenterology 2007: 2001: 2000: 1971: 1965: 1964: 1946: 1918: 1912: 1911: 1882: 1876: 1875: 1865: 1850:J Crohns Colitis 1841: 1835: 1834: 1832: 1830: 1819: 1813: 1812: 1783: 1777: 1776: 1758: 1734: 1728: 1727: 1699: 1693: 1692: 1682: 1650: 1644: 1643: 1633: 1618:Gastroenterology 1609: 1603: 1602: 1584: 1560: 1554: 1553: 1516: 1510: 1509: 1472: 1461: 1460: 1450: 1416: 1410: 1409: 1373: 1364: 1363: 1345: 1321: 1310: 1309: 1299: 1267: 1261: 1260: 1250: 1235:Gastroenterology 1226: 1220: 1219: 1209: 1199: 1167: 1161: 1160: 1158: 1148: 1124: 1118: 1117: 1115: 1105: 1081: 1075: 1074: 1046: 1040: 1039: 1029: 1005: 996: 995: 958: 952: 951: 941: 909: 903: 902: 892: 882: 858: 852: 851: 841: 817: 808: 807: 797: 787: 763: 754: 753: 717: 711: 710: 690: 684: 683: 673: 663: 639: 571:obeticholic acid 460:nuclear medicine 324:, stored in the 52:Gastroenterology 30: 21: 3592: 3591: 3587: 3586: 3585: 3583: 3582: 3581: 3552: 3551: 3550: 3541: 3506: 3495:Internal hernia 3381: 3326: 3291:Biliary fistula 3249: 3240: 3226:Adenomyomatosis 3221:Cholesterolosis 3197: 3191:Hemochromatosis 3062:Viral hepatitis 3034: 2983: 2941: 2927:Rectal prolapse 2896: 2863:Fecal impaction 2853:Intussusception 2816:Crohn's disease 2782: 2765:Toxic megacolon 2677: 2675:Large intestine 2669: 2614:Curling's ulcer 2567: 2565:Small intestine 2554: 2542: 2450:Gastroenteritis 2421: 2286: 2280: 2250: 2245: 2244: 2177: 2163: 2158: 2157: 2131: 2130: 2126: 2080: 2079: 2075: 2054:(10): 922–931. 2044: 2043: 2039: 2009: 2008: 2004: 1973: 1972: 1968: 1920: 1919: 1915: 1884: 1883: 1879: 1843: 1842: 1838: 1828: 1826: 1821: 1820: 1816: 1795:(11): 2549–58. 1785: 1784: 1780: 1736: 1735: 1731: 1701: 1700: 1696: 1652: 1651: 1647: 1611: 1610: 1606: 1562: 1561: 1557: 1518: 1517: 1513: 1474: 1473: 1464: 1418: 1417: 1413: 1375: 1374: 1367: 1323: 1322: 1313: 1269: 1268: 1264: 1228: 1227: 1223: 1169: 1168: 1164: 1126: 1125: 1121: 1083: 1082: 1078: 1048: 1047: 1043: 1020:(11): 1189–94. 1007: 1006: 999: 970:(10): 1077–80. 960: 959: 955: 911: 910: 906: 873:(12): 2340–57. 860: 859: 855: 819: 818: 811: 778:(1): 24–41.e1. 765: 764: 757: 719: 718: 714: 707: 692: 691: 687: 641: 640: 629: 624: 594: 543: 514:cholecystectomy 500:Crohn's disease 488: 470:Measurement of 452: 443: 430: 378: 358:large intestine 354:large intestine 342:small intestine 330:cholecystokinin 307: 302: 239: 107:cholecystectomy 28: 23: 22: 15: 12: 11: 5: 3590: 3588: 3580: 3579: 3574: 3569: 3564: 3554: 3553: 3547: 3546: 3543: 3542: 3540: 3539: 3534: 3532:Hemoperitoneum 3529: 3528: 3527: 3516: 3514: 3508: 3507: 3505: 3504: 3503: 3502: 3497: 3492: 3481: 3480: 3479: 3478: 3473: 3460: 3459: 3454: 3449: 3444: 3439: 3438: 3437: 3432: 3421: 3420: 3415: 3414: 3413: 3402: 3400: 3391: 3387: 3386: 3383: 3382: 3380: 3379: 3374: 3369: 3364: 3363: 3362: 3357: 3352: 3347: 3336: 3334: 3328: 3327: 3325: 3324: 3319: 3318: 3317: 3312: 3299: 3298: 3293: 3288: 3279: 3278: 3277: 3272: 3267: 3256: 3254: 3242: 3241: 3239: 3238: 3233: 3228: 3223: 3218: 3213: 3207: 3205: 3199: 3198: 3196: 3195: 3194: 3193: 3188: 3178: 3173: 3168: 3167: 3166: 3161: 3151: 3150: 3149: 3144: 3134: 3129: 3128: 3127: 3122: 3117: 3112: 3100: 3099: 3098: 3088: 3087: 3086: 3076: 3075: 3074: 3069: 3064: 3053: 3051: 3042: 3036: 3035: 3033: 3032: 3031: 3030: 3020: 3019: 3018: 3013: 3003: 3001:Blood in stool 2997: 2995: 2989: 2988: 2985: 2984: 2982: 2981: 2976: 2974:Anal dysplasia 2971: 2966: 2961: 2951: 2949: 2943: 2942: 2940: 2939: 2934: 2929: 2924: 2919: 2918: 2917: 2906: 2904: 2898: 2897: 2895: 2894: 2889: 2888: 2887: 2877: 2876: 2875: 2865: 2860: 2855: 2850: 2841: 2839:Angiodysplasia 2836: 2831: 2820: 2819: 2818: 2808: 2803: 2802: 2801: 2790: 2788: 2784: 2783: 2781: 2780: 2774:Diverticulosis 2770:Diverticulitis 2767: 2758: 2757: 2756: 2747: 2737: 2732: 2731: 2730: 2725: 2720: 2715: 2710: 2705: 2695: 2689: 2687: 2671: 2670: 2668: 2667: 2662: 2660:Milroy disease 2657: 2652: 2647: 2642: 2637: 2632: 2630:Tropical sprue 2627: 2618: 2617: 2616: 2606: 2605: 2604: 2599: 2594: 2583: 2581: 2558: 2552:Lower GI tract 2548: 2547: 2544: 2543: 2541: 2540: 2539: 2538: 2528: 2523: 2518: 2513: 2508: 2503: 2498: 2493: 2488: 2483: 2482: 2481: 2471: 2470: 2469: 2464: 2454: 2453: 2452: 2447: 2442: 2431: 2429: 2423: 2422: 2420: 2419: 2414: 2409: 2404: 2399: 2394: 2388: 2387: 2386: 2380: 2375: 2370: 2365: 2355: 2350: 2345: 2344: 2343: 2338: 2328: 2327: 2326: 2321: 2316: 2305: 2303: 2294: 2292:Upper GI tract 2288: 2287: 2281: 2279: 2278: 2271: 2264: 2256: 2247: 2246: 2243: 2242: 2231: 2220: 2209: 2194: 2178: 2173: 2172: 2170: 2169:Classification 2162: 2161:External links 2159: 2156: 2155: 2124: 2087:Clin Epidemiol 2073: 2037: 2018:(2): 569–571. 2002: 1983:(5): 808–820. 1966: 1913: 1894:(4): 321–331. 1877: 1856:(11): 1471–9. 1836: 1814: 1778: 1729: 1694: 1665:(12): 965–70. 1645: 1604: 1555: 1511: 1462: 1411: 1365: 1311: 1282:(10): 1232–9. 1262: 1221: 1162: 1139:(3): 299-312. 1119: 1096:(3): 299-312. 1076: 1041: 997: 953: 904: 853: 809: 755: 712: 705: 685: 654:(1): e000116. 626: 625: 623: 620: 593: 590: 550:Cholestyramine 542: 539: 538: 537: 530:celiac disease 506: 503: 487: 486:Classification 484: 451: 448: 442: 439: 429: 426: 377: 374: 322:biliary system 306: 303: 301: 298: 267:abdominal pain 238: 235: 198: 197: 194: 190: 189: 186: 182: 181: 178: 172: 171: 166: 160: 159: 150: 144: 143: 133: 127: 126: 117: 111: 110: 103: 99: 98: 95: 91: 90: 87: 83: 82: 79: 75: 74: 71: 65: 64: 61: 55: 54: 49: 43: 42: 39: 35: 34: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 3589: 3578: 3575: 3573: 3570: 3568: 3565: 3563: 3560: 3559: 3557: 3538: 3535: 3533: 3530: 3526: 3523: 3522: 3521: 3518: 3517: 3515: 3513: 3509: 3501: 3498: 3496: 3493: 3491: 3488: 3487: 3486: 3483: 3482: 3477: 3474: 3472: 3469: 3468: 3467: 3466: 3462: 3461: 3458: 3455: 3453: 3450: 3448: 3445: 3443: 3440: 3436: 3433: 3431: 3428: 3427: 3426: 3423: 3422: 3419: 3416: 3412: 3409: 3408: 3407: 3406:Diaphragmatic 3404: 3403: 3401: 3399: 3395: 3392: 3388: 3378: 3375: 3373: 3370: 3368: 3365: 3361: 3358: 3356: 3353: 3351: 3348: 3346: 3343: 3342: 3341: 3338: 3337: 3335: 3333: 3329: 3323: 3320: 3316: 3313: 3311: 3308: 3307: 3306: 3305: 3301: 3300: 3297: 3294: 3292: 3289: 3287: 3283: 3280: 3276: 3273: 3271: 3268: 3266: 3263: 3262: 3261: 3258: 3257: 3255: 3253: 3247: 3243: 3237: 3234: 3232: 3229: 3227: 3224: 3222: 3219: 3217: 3214: 3212: 3211:Cholecystitis 3209: 3208: 3206: 3204: 3200: 3192: 3189: 3187: 3184: 3183: 3182: 3179: 3177: 3174: 3172: 3169: 3165: 3162: 3160: 3157: 3156: 3155: 3154:Liver abscess 3152: 3148: 3145: 3143: 3140: 3139: 3138: 3137:Liver failure 3135: 3133: 3130: 3126: 3123: 3121: 3118: 3116: 3113: 3111: 3108: 3107: 3106: 3105: 3101: 3097: 3094: 3093: 3092: 3089: 3085: 3082: 3081: 3080: 3077: 3073: 3070: 3068: 3065: 3063: 3060: 3059: 3058: 3055: 3054: 3052: 3050: 3046: 3043: 3041: 3037: 3029: 3026: 3025: 3024: 3021: 3017: 3014: 3012: 3009: 3008: 3007: 3004: 3002: 2999: 2998: 2996: 2994: 2990: 2980: 2977: 2975: 2972: 2970: 2967: 2965: 2962: 2960: 2956: 2953: 2952: 2950: 2948: 2944: 2938: 2935: 2933: 2930: 2928: 2925: 2923: 2920: 2916: 2913: 2912: 2911: 2908: 2907: 2905: 2903: 2899: 2893: 2890: 2886: 2883: 2882: 2881: 2878: 2874: 2871: 2870: 2869: 2866: 2864: 2861: 2859: 2856: 2854: 2851: 2849: 2845: 2842: 2840: 2837: 2835: 2832: 2830: 2826: 2825: 2821: 2817: 2814: 2813: 2812: 2809: 2807: 2804: 2800: 2797: 2796: 2795: 2794:Enterocolitis 2792: 2791: 2789: 2785: 2779: 2775: 2771: 2768: 2766: 2762: 2759: 2755: 2751: 2748: 2746: 2743: 2742: 2741: 2738: 2736: 2733: 2729: 2726: 2724: 2721: 2719: 2716: 2714: 2711: 2709: 2706: 2704: 2701: 2700: 2699: 2696: 2694: 2691: 2690: 2688: 2685: 2681: 2676: 2672: 2666: 2663: 2661: 2658: 2656: 2653: 2651: 2648: 2646: 2643: 2641: 2638: 2636: 2633: 2631: 2628: 2626: 2622: 2621:Malabsorption 2619: 2615: 2612: 2611: 2610: 2607: 2603: 2600: 2598: 2595: 2593: 2590: 2589: 2588: 2585: 2584: 2582: 2579: 2575: 2571: 2566: 2562: 2559: 2557: 2553: 2549: 2537: 2534: 2533: 2532: 2529: 2527: 2524: 2522: 2519: 2517: 2514: 2512: 2509: 2507: 2504: 2502: 2499: 2497: 2496:Gastroparesis 2494: 2492: 2489: 2487: 2484: 2480: 2477: 2476: 2475: 2472: 2468: 2465: 2463: 2462:Cushing ulcer 2460: 2459: 2458: 2455: 2451: 2448: 2446: 2443: 2441: 2438: 2437: 2436: 2433: 2432: 2430: 2428: 2424: 2418: 2415: 2413: 2410: 2408: 2407:Megaesophagus 2405: 2403: 2400: 2398: 2395: 2392: 2389: 2384: 2381: 2379: 2376: 2374: 2371: 2369: 2366: 2364: 2361: 2360: 2359: 2356: 2354: 2351: 2349: 2346: 2342: 2339: 2337: 2334: 2333: 2332: 2329: 2325: 2322: 2320: 2317: 2315: 2312: 2311: 2310: 2307: 2306: 2304: 2302: 2298: 2295: 2293: 2289: 2285: 2277: 2272: 2270: 2265: 2263: 2258: 2257: 2254: 2241: 2237: 2236: 2232: 2230: 2226: 2225: 2221: 2219: 2215: 2214: 2210: 2208: 2204: 2203: 2199: 2195: 2193: 2189: 2188: 2184: 2180: 2179: 2176: 2171: 2167: 2160: 2151: 2147: 2143: 2139: 2135: 2128: 2125: 2120: 2116: 2111: 2106: 2101: 2096: 2093:: 1173–1181. 2092: 2088: 2084: 2077: 2074: 2069: 2065: 2061: 2057: 2053: 2049: 2041: 2038: 2033: 2029: 2025: 2021: 2017: 2013: 2006: 2003: 1998: 1994: 1990: 1986: 1982: 1978: 1970: 1967: 1962: 1958: 1954: 1950: 1945: 1944:10044/1/21617 1940: 1936: 1932: 1928: 1924: 1917: 1914: 1909: 1905: 1901: 1897: 1893: 1889: 1881: 1878: 1873: 1869: 1864: 1859: 1855: 1851: 1847: 1840: 1837: 1825: 1818: 1815: 1810: 1806: 1802: 1798: 1794: 1790: 1782: 1779: 1774: 1770: 1766: 1762: 1757: 1752: 1749:(9): 923–39. 1748: 1744: 1740: 1733: 1730: 1725: 1721: 1717: 1713: 1710:(3): 567–82. 1709: 1705: 1698: 1695: 1690: 1686: 1681: 1676: 1672: 1668: 1664: 1660: 1656: 1649: 1646: 1641: 1637: 1632: 1627: 1623: 1619: 1615: 1608: 1605: 1600: 1596: 1592: 1588: 1583: 1578: 1575:(8): 967–76. 1574: 1570: 1566: 1559: 1556: 1551: 1547: 1543: 1539: 1535: 1531: 1528:(2): 117–23. 1527: 1523: 1515: 1512: 1507: 1503: 1499: 1495: 1491: 1487: 1483: 1479: 1471: 1469: 1467: 1463: 1458: 1454: 1449: 1444: 1440: 1436: 1432: 1428: 1427: 1422: 1415: 1412: 1407: 1403: 1399: 1395: 1391: 1387: 1383: 1379: 1372: 1370: 1366: 1361: 1357: 1353: 1349: 1344: 1339: 1336:(7): 707–17. 1335: 1331: 1327: 1320: 1318: 1316: 1312: 1307: 1303: 1298: 1293: 1289: 1285: 1281: 1277: 1273: 1266: 1263: 1258: 1254: 1249: 1244: 1240: 1236: 1232: 1225: 1222: 1217: 1213: 1208: 1203: 1198: 1197:10044/1/87396 1193: 1189: 1185: 1181: 1177: 1173: 1166: 1163: 1157: 1152: 1147: 1142: 1138: 1134: 1130: 1123: 1120: 1114: 1109: 1104: 1099: 1095: 1091: 1087: 1080: 1077: 1072: 1068: 1064: 1060: 1056: 1052: 1045: 1042: 1037: 1033: 1028: 1023: 1019: 1015: 1011: 1004: 1002: 998: 993: 989: 985: 981: 977: 973: 969: 965: 957: 954: 949: 945: 940: 935: 931: 927: 924:(8): 1880–7. 923: 919: 915: 908: 905: 900: 896: 891: 886: 881: 876: 872: 868: 864: 857: 854: 849: 845: 840: 835: 831: 827: 823: 816: 814: 810: 805: 801: 796: 795:10044/1/76745 791: 786: 781: 777: 773: 769: 762: 760: 756: 751: 747: 743: 739: 735: 731: 727: 723: 716: 713: 708: 702: 698: 697: 689: 686: 681: 677: 672: 667: 662: 657: 653: 649: 645: 638: 636: 634: 632: 628: 621: 619: 617: 612: 609: 605: 603: 598: 591: 589: 586: 582: 578: 576: 572: 568: 563: 561: 557: 555: 551: 547: 540: 535: 531: 527: 523: 519: 515: 511: 507: 504: 501: 497: 496: 495: 493: 492:ileal disease 485: 483: 479: 477: 473: 468: 466: 461: 457: 449: 447: 440: 438: 436: 427: 425: 423: 419: 415: 411: 407: 403: 399: 395: 391: 387: 383: 375: 373: 371: 367: 363: 359: 355: 351: 347: 343: 339: 335: 331: 327: 323: 319: 315: 312:(also called 311: 304: 299: 297: 295: 291: 287: 283: 279: 275: 274:mental health 270: 268: 264: 260: 256: 252: 248: 244: 236: 234: 232: 228: 224: 221:secondary to 220: 219:malabsorption 216: 212: 208: 204: 195: 191: 187: 183: 179: 177: 173: 170: 167: 165: 161: 158: 154: 151: 149: 145: 142: 138: 134: 132: 128: 125: 121: 118: 116: 112: 108: 104: 100: 96: 92: 88: 84: 80: 76: 72: 70: 69:Complications 66: 62: 60: 56: 53: 50: 48: 44: 40: 36: 31: 19: 3484: 3463: 3340:Pancreatitis 3302: 3252:biliary tree 3125:Nutmeg liver 3102: 3028:Hematochezia 2979:Pruritus ani 2964:Anal abscess 2959:Anal fistula 2955:Anal fissure 2868:Constipation 2822: 2693:Appendicitis 2664: 2501:Gastroptosis 2491:Achlorhydria 2330: 2319:Eosinophilic 2233: 2222: 2211: 2196: 2181: 2133: 2127: 2090: 2086: 2076: 2051: 2047: 2040: 2015: 2011: 2005: 1980: 1976: 1969: 1929:(1): 54–64. 1926: 1922: 1916: 1891: 1887: 1880: 1853: 1849: 1839: 1827:. Retrieved 1817: 1792: 1788: 1781: 1746: 1742: 1732: 1707: 1703: 1697: 1662: 1658: 1648: 1624:(4): 752–7. 1621: 1617: 1607: 1572: 1568: 1558: 1525: 1521: 1514: 1481: 1477: 1433:(2): 124–6. 1430: 1424: 1414: 1384:(5): 561–7. 1381: 1377: 1333: 1329: 1279: 1275: 1265: 1238: 1234: 1224: 1182:(1): 20436. 1179: 1175: 1165: 1136: 1132: 1122: 1093: 1089: 1079: 1054: 1050: 1044: 1017: 1013: 967: 963: 956: 921: 917: 907: 870: 866: 856: 832:(5): 461–4. 829: 825: 775: 771: 725: 721: 715: 695: 688: 651: 647: 613: 610: 606: 599: 595: 592:Epidemiology 579: 564: 558: 544: 489: 480: 469: 458:test. This 453: 444: 431: 401: 393: 379: 308: 300:Pathogenesis 280:, including 271: 240: 210: 206: 202: 201: 115:Risk factors 109:, idiopathic 3520:Peritonitis 3282:Cholestasis 3260:Cholangitis 3203:Gallbladder 3091:Fatty liver 3011:Hematemesis 2993:GI bleeding 2799:Necrotizing 2728:Lymphocytic 2723:Collagenous 2718:Microscopic 2655:Steatorrhea 2556:Enteropathy 2402:Inlet patch 2324:Herpetiform 2309:Esophagitis 581:Liraglutide 560:Colesevelam 414:portal vein 326:gallbladder 251:steatorrhea 78:Usual onset 38:Other names 3556:Categories 3512:Peritoneal 3490:Incisional 3411:Congenital 3355:Hereditary 3332:Pancreatic 3296:Haemobilia 2969:Hemorrhoid 2947:Anal canal 2885:Infectious 2873:Functional 2708:Ulcerative 2592:Duodenitis 2531:Gastrinoma 2235:DiseasesDB 622:References 575:Tropifexor 554:colestipol 512:including 338:absorption 314:bile salts 310:Bile acids 294:depression 278:well-being 255:defecation 164:Medication 3500:Richter's 3457:Spigelian 3452:Obturator 3442:Umbilical 3275:Ascending 3246:Bile duct 3079:Cirrhosis 3057:Hepatitis 3040:Accessory 2910:Proctitis 2761:Megacolon 2735:Dysentery 2645:Whipple's 2597:Jejunitis 2587:Enteritis 2474:Dyspepsia 2435:Gastritis 2368:Achalasia 2301:Esophagus 1829:17 August 1057:: 66–70. 992:218908622 728:(3): 10. 541:Treatment 450:Diagnosis 334:digestion 286:dizziness 227:bile acid 196:Non-fatal 185:Frequency 176:Prognosis 47:Specialty 3567:Diarrhea 3430:Indirect 3425:Inguinal 3159:Pyogenic 3104:Vascular 2880:Diarrhea 2858:Volvulus 2824:Vascular 2763: / 2752: / 2713:Ischemic 2680:Appendix 2570:Duodenum 2440:Atrophic 2314:Candidal 2150:38717021 2119:38089008 2110:10712339 2068:35868334 2032:30965026 1997:32702169 1961:44661338 1953:25329562 1908:36758570 1872:24953836 1809:20109999 1773:12016216 1765:24602022 1591:23981126 1550:23867181 1498:26347530 1457:20437979 1406:27123642 1398:20932141 1360:11327665 1352:19570102 1306:23644387 1257:31843589 1216:33235223 1156:11307667 1113:11307667 1036:19426836 984:11589382 899:19498215 848:19817666 804:31526844 742:29582208 680:28123771 569:agonist 518:vagotomy 370:diarrhea 263:bloating 243:diarrhea 215:diarrhea 86:Duration 59:Symptoms 3471:Petit's 3447:Femoral 3350:Chronic 3164:Amoebic 2932:Anismus 2698:Colitis 2625:Coeliac 2602:Ileitis 2574:Jejunum 2427:Stomach 2331:Rupture 2229:C567652 1724:3742841 1689:1017717 1680:1411224 1640:5337211 1599:6386339 1542:8723414 1506:3454888 1448:4952080 1297:3783593 1207:7686486 1176:Sci Rep 1071:1298051 948:9109432 890:2781307 750:4419631 671:5253456 394:SLC10A2 386:taurine 364:in the 290:anxiety 282:fatigue 81:Any age 3465:Lumbar 3435:Direct 3418:Hiatus 3398:Hernia 3250:Other 3016:Melena 2902:Rectum 2385:(GERD) 2218:613291 2148:  2117:  2107:  2066:  2030:  1995:  1959:  1951:  1906:  1870:  1807:  1771:  1763:  1722:  1687:  1677:  1638:  1597:  1589:  1548:  1540:  1504:  1496:  1455:  1445:  1404:  1396:  1358:  1350:  1304:  1294:  1255:  1214:  1204:  1153:  1110:  1069:  1034:  990:  982:  946:  939:508012 936:  897:  887:  846:  802:  748:  740:  703:  678:  668:  536:, etc. 456:SeHCAT 193:Deaths 137:SeHCAT 102:Causes 3390:Other 3345:Acute 3096:MASLD 3049:Liver 3023:Lower 3006:Upper 2848:Ileus 2684:Colon 2578:Ileum 2393:(LPR) 2207:579.8 2192:K90.8 1957:S2CID 1769:S2CID 1595:S2CID 1546:S2CID 1502:S2CID 1402:S2CID 1356:S2CID 988:S2CID 746:S2CID 476:FGF19 435:FGF19 402:FABP6 382:ileum 366:colon 346:ileum 318:liver 94:Types 2778:SCAD 2240:6650 2224:MeSH 2213:OMIM 2202:9-CM 2146:PMID 2115:PMID 2064:PMID 2028:PMID 1993:PMID 1949:PMID 1904:PMID 1868:PMID 1831:2014 1805:PMID 1761:PMID 1720:PMID 1685:PMID 1636:PMID 1587:PMID 1538:PMID 1494:PMID 1453:PMID 1394:PMID 1348:PMID 1302:PMID 1253:PMID 1212:PMID 1067:PMID 1032:PMID 980:PMID 944:PMID 895:PMID 844:PMID 800:PMID 738:PMID 701:ISBN 676:PMID 583:, a 565:The 552:and 410:OSTβ 408:and 406:OSTα 380:The 336:and 276:and 265:and 3084:PBC 2811:IBD 2745:IBS 2198:ICD 2183:ICD 2138:doi 2105:PMC 2095:doi 2056:doi 2020:doi 2016:157 1985:doi 1939:hdl 1931:doi 1896:doi 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Index

Bile salt malabsorption
Specialty
Gastroenterology
Symptoms
Complications
cholecystectomy
Risk factors
Pelvic radiation disease
small intestinal bacterial overgrowth
Diagnostic method
SeHCAT
7α-hydroxy-4-cholesten-3-one
Differential diagnosis
Irritable bowel syndrome
microscopic colitis
Medication
Bile acid sequestrants
Prognosis
diarrhea
malabsorption
gastrointestinal disease
bile acid
bile acid sequestrants
diarrhea
Bristol stool scale
steatorrhea
defecation
fecal incontinence
bloating
abdominal pain

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