Bile acid malabsorption

Bile acid malabsorption, also called bile acid diarrhea, is a gastrointestinal disorder in which bile acids that should be reabsorbed in the small intestine instead pass into the colon, where they draw in water and salt and speed up gut transit. The result is chronic, often urgent diarrhea along with frequent, loose or watery bowel movements. The condition falls into recognized types: it can follow surgical removal of part of the ileum or the gallbladder, it can arise secondary to another underlying digestive disease, or it can occur with no identifiable cause, sometimes described as a primary disorder linked to excess bile acid production. It is also known by several other names, including cholerheic or choleretic enteropathy and bile salt diarrhea, reflecting decades of separate description before the mechanism was well understood. Estimates suggest it affects roughly one in 100 people, though it is frequently under-recognized because its symptoms overlap with irritable bowel syndrome. Once identified, it usually responds well to treatment with bile acid sequestrant medication.