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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 ]
If the pain is caused by biliary microlithiasis, oral ursodeoxycholic acid can alleviate the condition. [5] A trial of bile acid sequestrant therapy is recommended for bile acid diarrhea. [2] [8] Functional dyspepsia is subdivided into Epigastric Distress Syndrome (EPS) and Post-Prandial Distress Syndrome (PDS). [11]
When bile enters the duodenum (the first part of the small intestine), it aids in digesting the fat within food leaving the stomach. When the bile can not be properly propelled from the not-mechanically-obstructed gallbladder or can not flow out of the end of the common bile duct properly, there is a state of biliary dyskinesia.
Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver. Mere deposition of fat in the liver is termed steatosis, and together these constitute fatty liver changes.
Primary bile acid malabsorption, a gut defect in the reabsorption of bile acids in the small intestine which results in increased levels of bile acids in the colon leading to watery diarrhea and bloating. [31] Chronic infection of C. difficile, G. lamblia. C. difficile — bacteria that can be the source of diarrhea. [32]
The glycocholic acid breath test involves the administration of the bile acid 14 C glycocholic acid, and the detection of 14 CO 2, which would be elevated in bacterial overgrowth. [ citation needed ] However, some physicians suggest that if the suspicion of bacterial overgrowth is high enough, the best diagnostic test is a trial of treatment.
Persons with short bowel syndrome may have complications caused by malabsorption of vitamins and minerals, such as deficiencies in vitamins A, D, E, K, B 9 (folic acid), and B 12, calcium, magnesium, iron, and zinc. These may appear as anemia, hyperkeratosis (scaling of the skin), easy bruising, muscle spasms, poor blood clotting, and bone pain.
PSC is characterized by inflammation of the bile ducts (cholangitis) with consequent stricturing (i.e., narrowing) and hardening of these ducts due to scar formation, be it inside and/or outside the liver. [18] The resulting scarring of the bile ducts obstructs the flow of bile, which further perpetuates bile duct and liver injury.