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Bile acid crohn

Iain Alexander Murray, Linzi Karen Murray, Kathy Louise Woolson, Hisham Sherfi, Ivor Dixon, Joanne Palmer, Tom Sulkin
AIMS: To determine the value of (75)SeHCAT retention in determining bile acid diarrhoea (BAD), treatment response and predictors of a positive result. METHODS: Retrospective casenote review of consecutive patients undergoing (75)SeHCAT from 2008 to 2014, including gender, age, history, clinical, and laboratory parameters. This included diseases associated with Type 1 BAD (ileal resection, Crohn's disease) and Type 3 BAD. Chi-squared test and logistic regression determined factors predictive of BAD...
June 2017: Scandinavian Journal of Gastroenterology
Jonathan P Jacobs, Maryam Goudarzi, Namita Singh, Maomeng Tong, Ian H McHardy, Paul Ruegger, Miro Asadourian, Bo-Hyun Moon, Allyson Ayson, James Borneman, Dermot P B McGovern, Albert J Fornace, Jonathan Braun, Marla Dubinsky
BACKGROUND & AIMS: Microbes may increase susceptibility to inflammatory bowel disease (IBD) by producing bioactive metabolites that affect immune activity and epithelial function. We undertook a family based study to identify microbial and metabolic features of IBD that may represent a predisease risk state when found in healthy first-degree relatives. METHODS: Twenty-one families with pediatric IBD were recruited, comprising 26 Crohn's disease patients in clinical remission, 10 ulcerative colitis patients in clinical remission, and 54 healthy siblings/parents...
November 2016: Cellular and Molecular Gastroenterology and Hepatology
Lien Van den Bossche, Daniel Borsboom, Sarah Devriese, Sophie Van Welden, Tom Holvoet, Lindsey Devisscher, Pieter Hindryckx, Martine De Vos, Debby Laukens
Bile acids regulate the expression of intestinal bile acid transporters and are natural ligands for nuclear receptors controlling inflammation. Accumulating evidence suggests that signaling through these receptors is impaired in inflammatory bowel disease. We investigated whether tauroursodeoxycholic acid (TUDCA), a secondary bile acid with cytoprotective properties, regulates ileal nuclear receptor and bile acid transporter expression and assessed its therapeutic potential in an experimental model of Crohn's disease (CD)...
February 6, 2017: Laboratory Investigation; a Journal of Technical Methods and Pathology
Abigail Basson, Ashley Trotter, Alex Rodriguez-Palacios, Fabio Cominelli
Numerous reviews have discussed gut microbiota composition changes during inflammatory bowel diseases (IBD), particularly Crohn's disease (CD). However, most studies address the observed effects by focusing on studying the univariate connection between disease and dietary-induced alterations to gut microbiota composition. The possibility that these effects may reflect a number of other interconnected (i.e., pantropic) mechanisms, activated in parallel, particularly concerning various bacterial metabolites, is in the process of being elucidated...
2016: Frontiers in Immunology
João Sabino, Sara Vieira-Silva, Kathleen Machiels, Marie Joossens, Gwen Falony, Vera Ballet, Marc Ferrante, Gert Van Assche, Schalk Van der Merwe, Severine Vermeire, Jeroen Raes
OBJECTIVE: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease often leading to end-stage liver disease. Its pathogenesis remains largely unknown, although frequent concomitant IBD hints towards common factors underlying gut and bile duct inflammation. Considering the mounting evidence on the involvement of the intestinal microbiota in initiating and determining IBD phenotype, we investigated intestinal microbiota composition in patients with PSC. DESIGN: Stool samples were collected from 147 individuals (52 patients with PSC, 52 age, gender and body mass index-matched healthy volunteers, 13 UC and 30 patients with Crohn's disease)...
October 2016: Gut
Karen A Chachu, Mark T Osterman
Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract and includes both Crohn's disease and ulcerative colitis. Patients with IBD often present with abdominal pain, diarrhea, and rectal bleeding but may also have a wide variety of other symptoms such as weight loss, fever, nausea, vomiting, and possibly obstruction. Given that the presentation of IBD is not specific, the differential diagnosis is broad and encompasses a wide spectrum of diseases, many of which can mimic and/or even coexist with IBD...
May 2016: Inflammatory Bowel Diseases
Fiona Reid, Janet Peacock, Bola Coker, Viktoria McMillan, Cornelius Lewis, Stephen Keevil, Roy Sherwood, Gill Vivian, Robert Logan, Jennifer Summers
BACKGROUND: Bile acid malabsorption (BAM) is one possible explanation for chronic diarrhea. BAM may be idiopathic, or result from ileal resection or inflammation including Crohn's disease, or may be secondary to other conditions, including cholecystectomy, peptic ulcer surgery, and chronic pancreatitis. No "gold standard" exists for clinical diagnosis of BAM, but response to treatment with a bile acid sequestrant (BAS) is often accepted as confirmation. The SeHCAT (tauroselcholic [selenium-75] acid) test uses a radiolabeled synthetic bile acid and provides a diagnostic test for BAM, but its performance against "trial of treatment" is unknown...
February 1, 2016: JMIR Research Protocols
Emilie Vazeille, Benoit Chassaing, Anthony Buisson, Anaëlle Dubois, Amélie de Vallée, Elisabeth Billard, Christel Neut, Gilles Bommelaer, Jean-Frédéric Colombel, Nicolas Barnich, Arlette Darfeuille-Michaud, Marie-Agnès Bringer
BACKGROUND: Adherent-invasive Escherichia coli (AIEC) associated with Crohn's disease target M cells lining Peyer's patches (PPs) through the expression of long polar fimbriae (LPF) and survive macrophage killing. Invasion of PPs constitutes a way to colonize the mucosa for bacteria able to escape or resist killing of underlying immune cells. We aimed to identify new virulence factors involved in PPs colonization by AIEC. METHODS: The presence of gipA (Growth in PPs) gene was determined by polymerase chain reaction...
January 2016: Inflammatory Bowel Diseases
P Pavlidis, N Powell, R P Vincent, D Ehrlich, I Bjarnason, B Hayee
BACKGROUND: Inflammatory bowel diseases (IBD), comprising Crohn's disease and ulcerative colitis (UC), are chronic conditions attributed to an aberrant immune response to luminal triggers. Recently, published work suggests a pathogenic role for bile acids in this context. AIM: To perform a systematic review of studies investigating the role of bile acids in intestinal inflammation and present potentially relevant clinical implications. METHODS: Pubmed search for English language articles published up to May 2015...
October 2015: Alimentary Pharmacology & Therapeutics
Kate D Williamson, Roger W Chapman
INTRODUCTION: Primary sclerosing cholangitis (PSC) is a progressive cholestatic disorder that ultimately can lead to cirrhosis, liver failure, malignancy and death. It is strongly associated with inflammatory bowel disease (IBD), and though a rare disease, its incidence is increasing. There are no proven medical therapies for PSC. SOURCES OF DATA: Ovid Medline was utilised to search for articles with keywords 'sclerosing cholangitis' and 'cholangiocarcinoma' and containing titles 'primary sclerosing cholangitis', and references of these papers were cross-referenced for further relevant manuscripts...
June 2015: British Medical Bulletin
Michael Camilleri
Bile acid diarrhea (BAD) is usually seen in patients with ileal Crohn's disease or ileal resection. However, 25% to 50% of patients with functional diarrhea or diarrhea-predominant irritable bowel syndrome (IBS-D) also have evidence of BAD. It is estimated that 1% of the population may have BAD. The causes of BAD include a deficiency in fibroblast growth factor 19 (FGF-19), a hormone produced in enterocytes that regulates hepatic bile acid (BA) synthesis. Other potential causes include genetic variations that affect the proteins involved in BA enterohepatic circulation and synthesis or in the TGR5 receptor that mediates the actions of BA in colonic secretion and motility...
May 23, 2015: Gut and Liver
Imran Aziz, Saqib Mumtaz, Hassan Bholah, Fahmid U Chowdhury, David S Sanders, Alexander C Ford
BACKGROUND & AIMS: Some studies have found that patients with idiopathic bile acid diarrhea (BAD) present with symptoms of diarrhea-predominant irritable bowel syndrome (D-IBS). However, these studies either were retrospective, did not define D-IBS according to current criteria, or included patients with chronic functional diarrhea. We performed a prospective study of the prevalence of idiopathic BAD in consecutive patients fulfilling the Rome III criteria for D-IBS. METHODS: We analyzed data from 118 consecutive adult patients who fulfilled the Rome III criteria for D-IBS (mean age, 41...
September 2015: Clinical Gastroenterology and Hepatology
Jonathan D Nolan, Ian M Johnston, Sanjeev S Pattni, Tracy Dew, Timothy R Orchard, Julian R F Walters
BACKGROUND: Bile acids [BA] are usually reabsorbed by the terminal ileum, but this process is frequently abnormal in Crohn’s disease [CD]. BA malabsorption occurs, and excess colonic BA cause secretory diarrhea. Furthermore, the hormone fibroblast growth factor 19 [FGF19] is synthesized in the ileum in response to BA absorption and regulates BA synthesis. We hypothesized that reduced serum FGF19 levels will be associated with diarrheal symptoms and disease activity in both ileal resected[IR-CD] and non-resected CD [NR-CD] patients...
February 2015: Journal of Crohn's & Colitis
Alain Labbé, Jorge G Ganopolsky, Christopher J Martoni, Satya Prakash, Mitchell L Jones
We performed an analysis to determine the importance of bile acid modification genes in the gut microbiome of inflammatory bowel disease and type 2 diabetic patients. We used publicly available metagenomic datasets from the Human Microbiome Project and the MetaHIT consortium, and determined the abundance of bile salt hydrolase gene (bsh), 7 alpha-dehydroxylase gene (adh) and 7-alpha hydroxysteroid dehydrogenase gene (hsdh) in fecal bacteria in diseased populations of Crohn's disease (CD), Ulcerative Colitis (UC) and Type 2 diabetes mellitus (T2DM)...
2014: PloS One
Libor Vítek
Bile acid malabsorption (BAM) is a common but an underestimated and often neglected sign of inflammatory bowel diseases (IBDs), especially those affecting the distal ileum. Clinically relevant BAM is most often present in patients with Crohn's ileitis and particularly in ileal-resected Crohn's disease patients. However, deterioration of bile acid (BA) metabolism occurs also in patients with IBD without ileal disease or in those in clinical remission, and the role of BAM in these patients is not well appreciated by clinicians...
February 2015: Inflammatory Bowel Diseases
M Kurien, Jt Gleeson, C Osborne, L Messham, Ds Sanders
INTRODUCTION: Bile acid diarrhoea (BAD) is a recognised cause of chronic diarrhoea, however detection remains sub-optimal. Knowledge of factors predictive of BAD could help improve detection. This study evaluates factors predictive of BAD (7 day SeHCAT retention <10%) and determines long treatment outcomes in those instigated on medical therapy. METHODS: 515 patients underwent a SeHCAT test in a University hospital (2001-2012). Of these 41% (210/515) had evidence of BAD...
June 2014: Gut
Kl Woolson, H Sherfi, T Sulkin, J Palmer, Ia Murray
INTRODUCTION: Bile acid malabsorption (BAM) is increasingly recognised as the underlying diagnosis in many patients with D-IBS and Crohn's disease, and SeHCAT testing has greatly increased. The 2012 NICE consultation document (1) acknowledges lack of evidence of cost effectiveness and advocates trial of treatment with bile acid sequestrants (BAS) rather than SeHCAT for Crohn's patients, but often these are poorly tolerated and the response equivocal. We review our experience of SeHCAT testing and review it with respect to NICE...
June 2014: Gut
Jd Nolan, C Vassie, Im Johnston, D Shapiro, Jr Walters
INTRODUCTION: Chronic diarrhoea occurs frequently as a result of excess faecal bile acid (BA) loss. Secondary bile acid diarrhoea (SBAD) is common in Crohn's disease with ileal inflammation and/or resection. The normal ileum produces Fibroblast Growth Factor 19 (FGF19) in response to BA absorption and farnesoid X receptor (FXR) activation. FGF19 acts as a hormonal regulator of hepatic BA synthesis. We showed previously in 10 patients with primary bile acid diarrhoea, diagnosed by 7d SeHCAT retention <10%, that the semi-synthetic BA and potent FXR agonist obeticholic acid (OCA) significantly increased low FGF19 levels producing significant clinical improvement...
June 2014: Gut
I Aziz, S Mumtaz, H Bholah, Fu Chowdhury, Ds Sanders, Ac Ford
INTRODUCTION: Several studies have suggested that bile acid diarrhoea (BAD) can present with symptoms that are compatible with diarrhoea-predominant irritable bowel syndrome (IBS-D). However, uncertainty exists as these have often been retrospective, have not defined IBS-D according to accepted diagnostic criteria, or have included patients with chronic diarrhoea in the analysis. We have examined this issue in a well-characterised cohort of patients with rigorously defined IBS-D. METHODS: This was a prospective cross-sectional survey conducted among consecutive patients with IBS-D attending Gastroenterology clinics in two hospitals in Sheffield and Leeds, UK...
June 2014: Gut
Jörg Jahnel, Peter Fickert, Almuthe C Hauer, Christoph Högenauer, Alexander Avian, Michael Trauner
The enterohepatic circulation of bile acids (BAs) critically depends on absorption of BA in the terminal ileum and colon, which can be affected by inflammatory bowel disease (IBD). Diarrhea in IBD is believed to result in part from BA malabsorption (BAM). We explored whether IBD alters mRNA expression of key intestinal BA transporters, BA detoxifying systems, and nuclear receptors that regulate BA transport and detoxification. Using real-time polymerase chain reaction, mucosal biopsy specimens from the terminal ileum in Crohn's disease (CD) patients and from the descending colon in ulcerative colitis (UC) patients were assessed for mRNA expression...
September 2014: Drug Metabolism and Disposition: the Biological Fate of Chemicals
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