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Bile acid malabsorption (BAM), known also as bile acid diarrhea, is a cause of several gut-related problems, the main one being chronic diarrhea.It has also been called bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea or bile salt malabsorption.
These conjugated bile acids are often referred to as bile salts. The pKa of the unconjugated bile acids are between 5 and 6.5, [ 4 ] and the pH of the duodenum ranges between 3 and 5, so when unconjugated bile acids are in the duodenum, they are almost always protonated (HA form), which makes them relatively insoluble in water.
Without bile salts, most of the lipids in food would be excreted in feces, undigested. [9] Since bile increases the absorption of fats, it is an important part of the absorption of the fat-soluble substances, [10] such as the vitamins A, D, E, and K. [11]
Plus, high-fat foods cause the body to release bile salts and a hormone called cholecystokinin, which relaxes the lower esophageal sphincter, or LES, letting more acid wash up into the esophagus ...
In the lower small intestine and colon, bacteria dehydroxylate some of the primary bile salts to form secondary conjugated bile salts (which are still water-soluble). Along the proximal and distal ileum, these conjugated primary bile salts are reabsorbed actively into hepatic portal circulation. Bacteria deconjugate some of the primary and ...
Chronic diarrhea may be caused by excess bile salts entering the colon rather than being absorbed at the end of the small intestine (the ileum). This condition of bile acid malabsorption occurs after surgery to the ileum , in Crohn's disease , with a number of other gastrointestinal causes, or is commonly a primary, idiopathic condition.
D-xylose absorption test for mucosal disease or bacterial overgrowth. Normal in pancreatic insufficiency. Bile salt breath test (14 C-glycocholate) to determine bile salt malabsorption. Schilling test to establish cause of B 12 deficiency.
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