Kurien M et al. Frontline Gastroenterology 2018;9:92–97.
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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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Fakhoury M et al. J Inflamm Res 2014;7:113–120.
Aziz, I, Mumtaz S, Bholah H et al. Clin Gastroenterol Hepatol 2015;13:1650–1655.
Oduyebo I & Camilleri M. Curr Opin Gastroenterol 2017;33:189–195.
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).
Sainsbury A, Sanders D & Ford A. Clin Gastroenterol Hepatol 2013;11:359–365.
Watson L et al. Clin Med (Lond) 2015;15:536–540.
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.
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.
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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