Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea‐predominant irritable bowel syndrome

@article{Wedlake2009SystematicRT,
  title={Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea‐predominant irritable bowel syndrome},
  author={Linda Wedlake and Roger P. A’Hern and D Russell and Karen Thomas and J. R. F. Walters and H. Jervoise N. Andreyev},
  journal={Alimentary Pharmacology \& Therapeutics},
  year={2009},
  volume={30}
}
Background  Recurrent, watery diarrhoea affects one‐third of patients diagnosed with irritable bowel syndrome (‘IBS‐D’). Idiopathic bile acid malabsorption (‘I‐BAM’) may be the cause. 

Systematic review with meta‐analysis: the prevalence of bile acid malabsorption and response to colestyramine in patients with chronic watery diarrhoea and previous cholecystectomy

A limited number of small‐sized studies suggest that bile acid diarrhoea is frequent in patients with chronic watery diarrhoea and previous cholecystectomy.

Systematic review: the management of chronic diarrhoea due to bile acid malabsorption

Bile acid malabsorption (BAM) is a common, yet under‐recognised, cause of chronic diarrhoea, with limited guidance available on the appropriate management of patients with BAM.

Long‐term effect of medical treatment of diarrhoea in 377 patients with SeHCAT scan diagnosed bile acid malabsorption from 2003 to 2016; a retrospective study

TLDR
Diagnosis is possible by measuring the retention fraction of orally ingested 75Selenium homotaurocholic acid (SeHCAT), which indicates excessive amounts of bile acids entering the colon due to bile Acid malabsorption cause chronic bile acid diarrhoea.

Effect of colesevelam on faecal bile acids and bowel functions in diarrhoea‐predominant irritable bowel syndrome

About one‐third of patients with IBS‐diarrhoea (irritable bowel syndrome‐D) have evidence of increased bile acid synthesis or excretion.

Are bile acid malabsorption and bile acid diarrhoea important causes of loose stool complicating cancer therapy?

TLDR
This study assessed whether bile acid malabsorption or BAM or BAD are important causes of diarrhoea associated with cancer treatment.

Irritable Bowel Syndrome and Female Patients.

Review article: bile acid diarrhoea – pathogenesis, diagnosis and management

Bile acid diarrhoea results from imbalances in the homoeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease/dysfunction, associated with other GI

Prevalence of, and predictors of, bile acid malabsorption in outpatients with chronic diarrhea

TLDR
Yield of 23‐seleno‐25‐homo‐tauro‐cholic acid (SeHCAT) scanning in chronic diarrhea patients is examined, and predictors of a positive test are attempted to identify.

Review article: an analysis of safety profiles of treatments for diarrhoea‐predominant irritable bowel syndrome

  • B. Lacy
  • Medicine
    Alimentary pharmacology & therapeutics
  • 2018
TLDR
A broad range of therapies is available to manage symptoms of this common disorder, and a wide range of procedures are available to diagnose and treat IBS.

Screening for bile acid diarrhoea in suspected irritable bowel syndrome

TLDR
It is demonstrated that 18% of patients who meet criteria for IBS may have underlying bile acid diarrhoea (BAD), using 23-seleno-25-homo-tauro-cholic acid (SeHCAT) scanning.
...

References

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Idiopathic bile acid malabsorption: qualitative and quantitative clinical features and response to cholestyramine

TLDR
The SeHCAT (75Selenium HomotauroCholic Acid Test) can accurately diagnoseiopathic bile acid malabsorption and help identify and treat chronic diarrhoea.

Idiopathic bile acid catharsis.

TLDR
It is suggested that idiopathic bile acid catharsis should be suspected in patients with unexplained chronic diarrhoea and especially in those with a diagnosis of irritable colon with diarrhoeA.

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TLDR
It is indicated that BAM is common in patients with chronic diarrhoea, and is frequently found in IBS, and the results of open treatment suggest that, where antidiarrhoeal drugs fail in such patients, BAS are often effective.

Is bile acid malabsorption underdiagnosed? An evaluation of accuracy of diagnosis by measurement of SeHCAT retention.

The cause of intractable chronic diarrhoea was found to be malabsorption of bile acid in five out of 42 patients thought to have the irritable bowel syndrome, six out of 29 patients with persistent

Prognosis of adult-onset idiopathic bile acid malabsorption.

TLDR
The study confirms the reliability of the SeHCAT test in diagnosing IBAM, which shows that despite adult onset of symptoms, only a few patients improve after several years' observation.

Systematic Evaluation of the Causes of Chronic Watery Diarrhea With Functional Characteristics

TLDR
The diagnosis of functional disease in patients with chronic watery diarrhea should be performed with caution since in most cases there is an organic cause that justifies diarrhea.

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TLDR
Present data suggest that bile acids play no significant role in the pathogenesis of idiopathic diarrhoea, and cholestyramine is the treatment of choice and is virtually always effective in this syndrome.

Bile acid malabsorption in patients with chronic diarrhoea: clinical value of SeHCAT test.

TLDR
The SeHCAT test is of value in evaluation of patients with chronic diarrhoea as a second-line investigation with a high diagnostic yield and seems to predict the benefit of treatment with cholestyramine.

Use of the SeHCAT test in the investigation of diarrhoea.

TLDR
Patients with severe bile acid malabsorption demonstrated a good response to cholestyramine whereas the response in patients with a mildly abnormal SeHCAT retention was variable.

American Gastroenterological Association medical position statement: irritable bowel syndrome.

TLDR
The following guidelines were developed as an update to assist the physician in the clinical understanding, diagnosis, and management of patients with irritable bowel syndrome (IBS).