A source for healthcare professionals to access the latest data and information on the diagnosis, treatment and management of patients with gut related disorders

Key Studies

A selection of the most important published scientific papers are summarised as short texts highlighting the key findings of each study.

Challenging current views on bile acid diarrhoea and malabsorptiom

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

Guidance for the use of tauroselcholic (75selenium) acid (SeHCAT) for the investigation of diarrhoea due to bile acid malabsorption (BAM) in patients with diarrhoea-predominant irritable bowel syndrome (IBS-D) and or Crohn’s disease without ileal resection is outlined in diagnostics guidance 7 (DG7). A review of DG7 in 2012 by the National Institute for Health and Care Excellence (NICE) determined that SeHCAT should be recommended for research purposes only. This study describes relevant information made available since this review and investigates the economic consequences of misdiagnosis or inefficient treatment of bile acid diarrhoea (BAD) and BAM.

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Inflammatory bowel disease: clinical aspects and treatments

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

Inflammatory bowel disease (IBD) is a chronic disease for which there is no cure. This review describes the types and symptoms of IBD, the role of cytokines in the inflammation process and the diagnostic and treatment options.

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High prevalence of idiopathic bile acid diarrhoea among patients with diarrhoea-predominant irritable bowel syndrome based on Rome III criteria

Aziz, I, Mumtaz S, Bholah H et al. Clin Gastroenterol Hepatol 2015;13:1650–1655.

Nearly 25% of patients presenting with diarrhoea-predominant irritable bowel syndrome (IBS-D) have mild to moderate idiopathic bile acid diarrhea (BAD), according to this UK-based study. The severity of BAD in these patients was associated with impaired physical activity. 

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Bile acid disease: the emerging epidemic 

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

Type 2 (primary) bile acid diarrhoea (BAD) is associated with increased bile acid production and occurs in nearly 30% of patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). Primary BAD is associated with disorders of serum fibroblast growth factor 19 (FGF-19) which results in excess bile acid synthesis by hepatocytes. This leads to higher concentrations of bile acids in the colon and increased faecal bile acid loss.

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Brief report: length of ileal resection correlates with severity of bile acid malabsorption in Crohn’s disease  

Skouras T et al. Int J Colorectal Dis2018; doi:10.1007/s00384-018-3144-1.

In patients with Crohn’s disease who had a prior surgical resection there was a modest correlation between the length of ileal resection and the severity of bile acid malabsorption (BAM), as defined by tauroselcholic (75selenium) acid (SeHCAT) retention values. Response to bile salt sequestrant therapy was not dependent on SeHCAT retention values.

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Diagnosis and management of inflammatory bowel disease

Nightingale A. Nurse Prescribing 2007;5:289–296.

Inflammatory bowel disease (IBD)—comprising ulcerative colitis (UC) and Crohn’s disease—is a chronic condition that affects about 1 in 700 people in the UK. Symptoms are variable and are generally related to the site of disease and its severity. Since many conditions can mimic IBD, accurate diagnosis is essential to select the most appropriate and effective treatment.

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Some patients with irritable bowel syndrome may have exocrine pancreatic insufficiency

Leeds J et al. Clin Gastroenterol Hepatol 2010;8:433–438.

Diarrhoea and abdominal pain are common symptoms of irritable bowel syndrome (IBS), which can cause psychological stress and reduction in the quality of life in affected patients.

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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.

A high proportion of patients with coeliac disease (CD) experience symptoms similar to irritable bowel syndrome (IBS). 

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Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Teruel C et al. World J Gastrointest Pharmacol Ther 2016;7:78–90.

Patients with inflammatory bowel disease (IBD) frequently experience symptoms similar to irritable bowel syndrome (IBS) whilst in remission. Although in remission, IBD patients with IBS have an impaired quality of life and are more likely to experience anxiety or depression than their asymptomatic counterparts. IBD-IBS is likely to be secondary to other factors, such as increased epithelial permeability, colonic dysmobility and intestinal hypersensitivity.


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Management of bile acid malabsorption using low-fat dietary interventions: a useful strategy applicable to some patients with IBS-D?

Watson L et al. Clin Med (Lond) 2015;15:536–540.

Simple low–fat dietary interventions can result in clinically important improvements in gastrointestinal (GI) symptoms due to bile acid malabsorption (BAM) according to the results of this UK study.

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Bowel disorders

Lacey B et al. Gastroenterology 2016;150:1393–1407.

The identification and diagnosis of functional bowel disorders is challenging. These disorders are very common and patients typically present with abdominal pain, distention, bloating and/or change in bowel habits. 

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