TY - JOUR
T1 - Bile acid diarrhea-As bad as it gets?
AU - Bousaba, Joelle
AU - Camilleri, Michael
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Purpose of reviewBile acid diarrhea (BAD) is a common but under-recognized gastrointestinal condition that manifests with increased stool frequency and urgency, and a looser stool consistency. The aim of this review is to present recent advances in the pathophysiology, mechanisms, manifestations, diagnosis, and treatment of BAD.Recent findingsPatients with BAD have evidence of accelerated colonic transit, increased gut mucosal permeability, altered stool microbiome composition, and decreased quality of life. Single, random stool measurements of bile acids, alone or in combination with fasting serum 7-alpha-hydroxy-4-cholesten-3-one, have shown good sensitivity and specificity for the diagnosis of BAD. Novel therapeutic approaches include farnesoid X receptor agonists and glucagon-like peptide 1 agonists.SummaryRecent research has led to a better understanding of the pathophysiology and mechanisms of BAD, which might pave the way towards more targeted treatment strategies for BAD. Newer, more affordable, and easier diagnostic methods facilitate the diagnosis of BAD.
AB - Purpose of reviewBile acid diarrhea (BAD) is a common but under-recognized gastrointestinal condition that manifests with increased stool frequency and urgency, and a looser stool consistency. The aim of this review is to present recent advances in the pathophysiology, mechanisms, manifestations, diagnosis, and treatment of BAD.Recent findingsPatients with BAD have evidence of accelerated colonic transit, increased gut mucosal permeability, altered stool microbiome composition, and decreased quality of life. Single, random stool measurements of bile acids, alone or in combination with fasting serum 7-alpha-hydroxy-4-cholesten-3-one, have shown good sensitivity and specificity for the diagnosis of BAD. Novel therapeutic approaches include farnesoid X receptor agonists and glucagon-like peptide 1 agonists.SummaryRecent research has led to a better understanding of the pathophysiology and mechanisms of BAD, which might pave the way towards more targeted treatment strategies for BAD. Newer, more affordable, and easier diagnostic methods facilitate the diagnosis of BAD.
KW - 7-alpha-hydroxy-4-cholesten-3-one
KW - fibroblast growth factor-19
KW - mRNA
KW - permeability
KW - sequestrants
UR - http://www.scopus.com/inward/record.url?scp=85159332543&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85159332543&partnerID=8YFLogxK
U2 - 10.1097/MOG.0000000000000916
DO - 10.1097/MOG.0000000000000916
M3 - Review article
C2 - 37144536
AN - SCOPUS:85159332543
SN - 0267-1379
VL - 39
SP - 184
EP - 191
JO - Current Opinion in Gastroenterology
JF - Current Opinion in Gastroenterology
IS - 3
ER -