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Primary bile acid diarrhea (Type 2 bile acid "malabsorption") may be caused by an overproduction of bile acids. [5] [9] Several groups of workers have failed to show any defect in ileal bile acid absorption in these patients, and they have an enlarged bile acid pool, rather than the reduced pool expected with malabsorption. [10]
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. The SeHCAT test can be used for diagnosis. Bile salt diarrhea can also be a side-effect of gallbladder removal. [1]
These side effects often lead to low patient compliance. [5] Colesevelam can be used instead of cholestyramine in symptomatic chronic diarrhea due to bile salt malabsorption (bile acid diarrhea), which can be a primary condition, or secondary to Crohn's disease or the postcholecystectomy syndrome. [6] [7] [8]
Colestyramine is commonly used to treat diarrhea resulting from bile acid malabsorption. [2] It was first used for this in Crohn's disease patients who had undergone ileal resection. [3] The terminal portion of the small bowel (ileum) is where bile acids are reabsorbed. When this section is removed, the bile acids pass into the large bowel and ...
However, it has little benefit in improving acute diarrhea in children. [116] Bile acid sequestrants such as cholestyramine can be effective in chronic diarrhea due to bile acid malabsorption. Therapeutic trials of these drugs are indicated in chronic diarrhea if bile acid malabsorption cannot be diagnosed with a specific test, such as SeHCAT ...
Colestipol (trade names Colestid, Cholestabyl) is a bile acid sequestrant used to lower blood cholesterol, specifically low-density lipoprotein (LDL). [1] [2] It is also used to reduce stool volume and frequency, and in the treatment of chronic diarrhea. [3]
Diarrhea, weight loss, flatulence, abdominal bloating, abdominal cramps, and pain may be present. Although diarrhea is a common complaint, the character and frequency of stools may vary considerably ranging from over 10 watery stools per day to less than one voluminous putty-like stool, the latter causing some patients to complain of constipation.
Chronic diarrhea in postcholecystectomy syndrome is a type of bile acid diarrhea (type 3). [3] This can be treated with a bile acid sequestrant like cholestyramine, [3] colestipol [2] or colesevelam, [7] which may be better tolerated. [8]