gutNEWS.org

Welcome to GutNEWS.org

A new web hub focussed on providing gastroenterologists with the latest information on the diagnosis, treatment and management of patients with gut related disorders.

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Welcome to GutNEWS.org

Challenging current views on bile acid diarrhoea and malabsorption

Kurien M et al. Frontline Gastroenterology 2018;9:92–97.

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Challenging current views on bile acid diarrhoea and malabsorption

Symptoms of irritable bowel syndrome

Dr. Fermín Mearin-Manrique

Symptoms in this patient point towards a diagnosis of irritable bowel syndrome (IBS)

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Symptoms of irritable bowel syndrome / Dr Fermín Mearin-Manrique

Diarrhoea symptoms in inflammatory bowel disease

Dr Jordi Guardiola

We do not know exactly why patients with inflammatory bowel disease (IBD) have clinical symptoms. There is no correlation between endoscopic lesions and the clinical manifestations assessed by the Crohn’s disease activity index.

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Diarrhoea symptoms in inflammatory bowel disease / Dr Jordi Guardiola
Inflammatory bowel disease: clinical aspects and treatments

Inflammatory bowel disease: clinical aspects and treatments

Fakhoury M et al. J Inflamm Res 2014;7:113–120.

 
 
Bile acid disease: the emerging epidemic 

Bile acid disease: the emerging epidemic 

Oduyebo I & Camilleri M. Curr Opin Gastroenterol 2017;33:189–195.

 
Physiology of bile acid diarrhoea

 / Professor Julian R.F. Walters

Physiology of bile acid diarrhoea

Bile acid diarrhoea (BAD) is a common but under-recognised cause of chronic functional diarrhoea, accounting for up to a third of patients who otherwise would be labelled as diarrhoea-predominant irritable bowel syndrome (IBS-D).

 
Prevalence of irritable bowel syndrome–type symptoms in patients with celiac disease: a meta-analysis

 / Professor David S. Sanders

Prevalence of irritable bowel syndrome–type symptoms in patients with celiac disease: a meta-analysis

Sainsbury A, Sanders D & Ford A. Clin Gastroenterol Hepatol 2013;11:359–365.

 

Expert Opinion

Are the current treatments for bile acid diarrhoea effective (BAD), and is it likely that in the future there will be better treatments for BAD?

 / Professor Julian R.F. Walters

Professor Julian R.F. Walters

Are the current treatments for bile acid diarrhoea effective (BAD), and is it likely that in the future there will be better treatments for BAD?

Current therapies, such as colestyramine and colesevelam, bind and eliminate bile acids from the colon. These drugs prevent the excess bile acids causing watery faeces. 

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Expert Opinion

Is bile acid diarrhoea underdiagnosed in patients with Crohn’s disease?

 / Dr Jordi Guardiola

Jordi Guardiola

Is bile acid diarrhoea underdiagnosed in patients with Crohn’s disease?

Definitely, yes. Unfortunately for patients with Crohn’s disease, there is a poor relationship between their symptoms and intestinal inflammation, and a considerable proportion of patients’ present symptoms that are not due to the inflammation but rather to bile acid diarrhoea. 

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Expert Opinion

What is the overall benefit for clinicians of an early diagnosis of bile acid diarrhoea?

 / Professor David S. Sanders

Professor David S. Sanders

What is the overall benefit for clinicians of an early diagnosis of bile acid diarrhoea?

The benefit is quite significant, both for the physician and for the patient. For physicians, it provides the possibility to avoid numerous diagnostic tests.

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