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Bile Acid Malabsorption Related to Chronic Diarrhea

Eur J Gastroenterol Hepatol 2000;12:541-547.

(Celiac.com 07/09/2000) Researchers in Sweden released a report that shows a high number of patients with chronic diarrhea also have bile acid malabsorption. Further, steatorrhea is also common, but appears to be independent of bile acid malabsorption. Their study evaluated 94 patients with chronic diarrhea for loss of bile acids using both 75-SeHCAT and a fecal fat excretion tests. The patients also completed a symptom questionnaire before during a 7 day period before taking the 75-SeHCAT test.

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Dr. Kjell-Arne Ung and his colleagues from Sahlgrenska University Hospital, in Goteborg reported their finding in the the May issue of the European Journal of Gastroenterology and Hepatology. They found that mild steatorrhea was present in 50% of patients with non-organic bile acid malabsorption, and in 38% of patients with functional diarrhea. Further, low 75-SeHCAT levels alone is not an indicator or risk for steatorrhea, although some patients with severe organic disease had a concomitant malabsorption of fat and of bile acids. Dr. Ungs study also shows that severe steatorrhea was common in patients with celiac disease, even in patients with high 75-SeHCAT values.

When compared with patients who had functional diarrhea, those with bile acid malabsorption had significantly more frequent and looser stools, however, abdominal pain, distension and flatulence was equal between those with bile acid malabsorption and normal bile acid absorption.

In conclusion Dr. Ung and colleagues state: The high prevalence of bile acid malabsorption and the absence of specific symptoms, with the exception of frequent and liquid stools, indicates that the 75-SeHCAT test should be performed early in the investigation of patients with chronic diarrhea.

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