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A source for healthcare professionals to access the latest data and information on the diagnosis, treatment and management of patients with gut related disorders
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.
This was a prospective dual-centre study involving adults who fulfilled the Rome III criteria for IBS-D. Patients with known risk factors for BAD were excluded from the study. The study included 118 individuals with a mean age of 41.7 years. The total prevalence of BAD was 23.7% (n=28) using a tauroselcholic (75selenium) acid SeHCAT retention score of less than 15% to define the presence of BAD. The prevalence was statistically similar across both study sites.
Analysis of the results showed that individuals with BAD were significantly more likely to have a high body mass index (BMI) than individuals without BAD (31.6 kg/m2 vs 26.4 kg/m2, P=0.003). Patients with severe/moderate BAD had significant physical activity impairment when compared with patients with mild BAD (p=0.046).
The findings of this study question whether symptom-based criteria will positively diagnose IBS-D without the need to exclude possible underlying organic pathology, and clearly show that idiopathic BAD can masquerade as BAD. Future guidelines should therefore include diagnostic testing to exclude BAD before a diagnosis of IBS-D is made.
Job number: JB57410GBx Date of Preparation: June 2019
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Brief report: length of ileal resection correlates with severity of bile acid malabsorption in Crohn’s disease
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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