Bile acid malabsorption investigated by selenium-75-homocholic acid taurine (⁷⁵SeHCAT) scans: Causes and treatment responses to cholestyramine in 298 patients with chronic watery diarrhoea

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• 作者：Mä ; rta K. Borghede^a ;   ; ^{marta.borghede@gmail.com} ; Jacob M. Schlü ; tter^a ; Jø ; rgen S. Agnholt^a ; Lisbet A. Christensen^a ; Lars C. Gormsen^b ; Jens F. Dahlerup^a ;   ; ¹ ;   ; ^{jensdahl@rm.dk}
• 关键词：Bile acid malabsorption ; Cholestyramine ; Bile acid sequestrant ; Selenium-75-homocholic acid taurine (⁷⁵SeHCAT)
• 刊名：European Journal of Internal Medicine
• 出版年：2011
• 出版时间：December 2011
• 年：2011
• 卷：22
• 期：6
• 页码：e137-e140
• 全文大小：156 K

文摘

Background

The liver produces and secretes bile acids into the small intestine. In the small intestine, most of the bile acids are absorbed in the distal ileum with portal vein transportation back to the liver and resecretion (enterohepatic recycling). Increased spillover of bile acids from the small intestine into the colon (bile acid malabsorption) may affect the secretion of colonic water and electrolytes and result in watery diarrhoea.

The aim of this study was to investigate the frequency of bile acid malabsorption and treatment responses to cholestyramine with ⁷⁵SeHCAT scanning among patients suffering from chronic watery diarrhoea.

Methods

This was a retrospective study that included all patients who received a ⁷⁵SeHCAT scan over a five-year period (2004?009).

Results

In total, 298 patients (198 females, 100 men) with a median age of 42 years (range 16?2 years) were investigated.

Bile acid malabsorption (⁷⁵SeHCAT retention < 15 % after seven days) was identified in 201 patients (68 % , 95 % confidence interval (CI): 62 % ?3 % ). Bile acid malabsorption due to ileal dysfunction (Type I) was found in 77 patients, idiopathic bile acid malabsorption (Type II) was found in 68 patients and 56 patients with other conditions had bile acid malabsorption (Type III).

Of the 150 patients who were able to take cholestyramine continuously, 108 patients (71 % , CI: 63 % ?8 % ) reported a positive effect on their bowel habits.

Conclusions

Bile acid malabsorption is a frequent problem in patients with chronic watery diarrhoea. Treatment with bile acid binders was effective regardless of type and severity.