Bile acid malabsoption: a forgotten diagnosis?
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.
Khalid
Usman
U
Department of Medicine, Royal Marsden Hospital, London.
Lalji
Amyn
A
Stafferton
Ruth
R
Andreyev
Jervoise
J
D001647:Bile Acids and Salts / Q000378:metabolism; D003113:Colonoscopy; D005762:Gastroenterology; D019538:Health Care Surveys; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis; D008286:Malabsorption Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D012812:Sigmoidoscopy
D001647:Bile Acids and Salts