doi: 10.7861/clinmedicine.10-2-124.
Bile acid malabsoption: a forgotten diagnosis?
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- PMID:20437979
- PMCID: PMC4952080
- DOI: 10.7861/clinmedicine.10-2-124
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Bile acid malabsoption: a forgotten diagnosis?
Usman Khalid et al. Clin Med (Lond).2010 Apr.
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Abstract
Bile acid malabsorption (BAM) is never life threatening but can cause chronic symptoms. A survey of senior British gastroenterologists was conducted to examine their approach to patients with potential BAM. Of the 706 gastroenterologists contacted, 62% replied. Gastroenterologists see on average 500 new patients in clinic annually; 34% have chronic diarrhoea and 1% are diagnosed with BAM. In those with chronic diarrhoea, 6% of gastroenterologists investigate for BAM first line, while 61% consider the diagnosis only in selected patients or not at all. Sixty-one per cent of patients are diagnosed with type 1 BAM (secondary to terminal ileal disease), 22% have type 2 (idiopathic bile acid malabsorption) and 15% type 3 (unrelated to terminal ileal disease). Only one third of gastroenterologists use a definitive diagnostic test for BAM. BAM (particularly type 2) is under-diagnosed because it is frequently not considered and even when considered, many patients are not subjected to definitive diagnostic testing.
Figures
Test of choice used by each gastroenterologist to diagnose patients with bile acid malabsorption.
Treatments used for patients diagnosed with bile acid malabsorption.
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