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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.
Bile salts constitute a large family of molecules, composed of a steroid structure with four rings, a five- or eight-carbon side-chain terminating in a carboxylic acid, and several hydroxyl groups, the number and orientation of which is different among the specific bile salts.
Bile salts interfere with the gastric mucosal barrier, allowing acid to irritate the stomach lining and cause gastritis. [1] Dogs with this condition usually vomit in the morning after not eating all night. Treatment is to feed late at night. H2 blockers and antiemetics can also be used. Bilious vomiting syndrome is a diagnosis of exclusion ...
Bile salt diarrhea can also be a side-effect of gallbladder removal. [1] Bile acid sequestrants are the principal therapy for bile acid-induced diarrhea. [7] [1] Cholestyramine, colestipol and colesevelam have all been used. Doses may not need to be as high as those previously used for hyperlipidemia.
Bile salt hydrolases are members of the N-terminal nucleophilic hydrolase family, characterized by autocatalytic activation by an N-terminal nucleophile and subsequent amide bond cleavage. [ 2 ] [ 5 ] The majority of BSH enzymes are composed of homotetramers , although they have been known to assume other forms including homodimers and ...
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 ...
Additionally the composition of biliary sludge has been suggested to encourage the formation of a mucocele. Biliary sludge occurs when more water or mucin is reabsorbed and there is excessive bile salts. As this progresses more water is increased causing the contents to become more solid and severely decrease the motility of the gallbladder [7]
The most common side effects include peripheral neuropathy (nerve damage in the hands and feet), diarrhea, nausea (feeling sick), acid reflux (stomach acid flowing up into the mouth), esophagitis (inflammation of the food pipe), jaundice (yellowing of the skin and eyes), skin problems (lesions) and malaise (feeling unwell).