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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2013, Number 2

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Rev Esp Med Quir 2013; 18 (2)

Idiopathic Malabsorption of Bile Acids as a Cause of Chronic Diarrhea in Adults

Irineo CAB, Zambada SCA, Sánchez CJA, Bernal MG

Language: Spanish
References: 25
Page: 158-162
PDF size: 323.84 Kb.


ABSTRACT

The intestinal symptoms, such as diarrhea, can occur when excess bile acids are present in the colon. This condition is known as bile acid malabsorption and has been studied with the best method of diagnosis, SeHCAT (Selenium Acid Homocholic Taurine), which is not available in many countries, such as USA and Mexico. A number of studies show abnormal tests SeHCAT up to 30% of patients diagnosed as irritable bowel syndrome or diarrhea-predominant functional diarrhea, with an estimated prevalence in the population of about 1%. Currently, it is suggested that bile acid malabsorption results in an increased production due to a disorder in the negative feedback ileal hormone fibroblast growth factor (FGF19). The theory states that the absorption of bile acids in the ileum enterocytes fail to generate appropriate levels of FGF19. Current treatment is based on creating superior bile acid unions to reduce their secretory actions, using cholestyramine, more recently, colesevelam. The colesevelam has potential advantages that merit further investigation in trials to patients whit diarrhea bile acid malabsortion. This article reviews the pathophysiology chronic diarrhea bile acid malabsortion, diagnosis and therapeutic alternatives.


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