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Bile acid malabsorption

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https://www.readbyqxmd.com/read/27856362/colonic-transit-and-bile-acid-synthesis-or-excretion-in-patients-with-irritable-bowel-syndrome-diarrhea-without-bile-acid-malabsorption
#1
Cédric Peleman, Michael Camilleri, Irene Busciglio, Duane Burton, Leslie Donato, Alan R Zinsmeister
: bile acid malabsorption (BAM). BAs are passively absorbed to a different extent along the mammalian colon, so that levels are lower in the feces than in proximal colon. Our aim was to explore associations among total, primary, and secretory BA in stool and colonic transit in patients with irritable bowel syndrome-diarrhea (IBS-D) without overt BAM. METHODS: In a cross-sectional observational study of 116 patients with IBS-D recruited from local communities in Minnesota, we measured total and individual main fecal BA excretion, fecal fat and fecal weight over 48 hrs, fasting serum levels of C4 (surrogate for BA synthesis), and overall colonic transit by scintigraphy (geometric center at 24 hrs and 48 hrs)...
November 14, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27818587/improved-glucose-metabolism-following-bariatric-surgery-is-associated-with-increased-circulating-bile-acid-concentrations-and-remodeling-of-the-gut-microbiome
#2
REVIEW
Lukasz Kaska, Tomasz Sledzinski, Agnieszka Chomiczewska, Agnieszka Dettlaff-Pokora, Julian Swierczynski
Clinical studies have indicated that circulating bile acid (BA) concentrations increase following bariatric surgery, especially following malabsorptive procedures such as Roux-en-Y gastric bypasses (RYGB). Moreover, total circulating BA concentrations in patients following RYGB are positively correlated with serum glucagon-like peptide-1 concentrations and inversely correlated with postprandial glucose concentrations. Overall, these data suggest that the increased circulating BA concentrations following bariatric surgery - independently of calorie restriction and body-weight loss - could contribute, at least in part, to improvements in insulin sensitivity, incretin hormone secretion, and postprandial glycemia, leading to the remission of type-2 diabetes (T2DM)...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27777930/characterization-of-aqps-in-mouse-rat-and-human-colon-and-their-selective-regulation-by-bile-acids
#3
Jonathan Yde, Stephen Keely, Qi Wu, Johan F Borg, Natalia Lajczak, Aoife O'Dwyer, Peter Dalsgaard, Robert A Fenton, Hanne B Moeller
In normal individuals, the epithelium of the colon absorbs 1.5-2 l of water a day to generate dehydrated feces. However, in the condition of bile acid malabsorption (BAM), an excess of bile acids in the colon results in diarrhea. Several studies have attempted to address the mechanisms contributing to BAM induced by various bile acids. However, none have addressed a potential dysregulation of aquaporin (AQP) water channels, which are responsible for the majority of transcellular water transport in epithelial cells, as a contributing factor to the onset of diarrhea and the pathogenesis of BAM...
2016: Frontiers in Nutrition
https://www.readbyqxmd.com/read/27765536/-75-sehcat-scan-in-bile-acid-malabsorption-in-chronic-diarrhoea
#4
L M Mena Bares, E Carmona Asenjo, M V García Sánchez, E Moreno Ortega, F R Maza Muret, M V Guiote Moreno, A M Santos Bueno, E Iglesias Flores, J M Benítez Cantero, J A Vallejo Casas
Chronic diarrhoea is a common entity in daily clinical practice and it leads to a loss in these patients quality of life. It may be the main symptom of multiple ethiologies including bile acid malabsorption (BAM) which has a comparable prevalence to celiac disease. The BAM results from imbalances in the homeostasis of bile acids in the enterohepatic circulation. It can be a consequence of ileal disease or ileal dysfunction (BAM type i), it can be considered idiopathic or primary (BAM type ii) or associated with other gastrointestinal entities (BAM type iii)...
October 17, 2016: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/27671525/physiological-and-molecular-responses-to-bariatric-surgery-markers-or-mechanisms-underlying-t2dm-resolution
#5
Chelsea R Hutch, Darleen A Sandoval
Bariatric surgery is currently the most effective treatment for obesity and associated comorbidities, including rapid resolution of type 2 diabetes mellitus (T2DM). Although the weight loss itself has substantial impact, bariatric surgery also has weight loss-independent effects on T2DM. Several variations of bariatric surgery exist, including the widely studied Roux-en-Y gastric bypass and vertical sleeve gastrectomy. The success of both of these bariatric surgeries was originally attributed to restrictive and malabsorptive modes of action; however, mounting evidence from both human and animal studies implicates mechanisms beyond surgery-induced mechanical changes to the gastrointestinal (GI) system...
September 26, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27616761/a-systematic-literature-search-and-review-of-sodium-concentrations-of-body-fluids%C3%A2
#6
Elaine M Kaptein, Divya Sreeramoju, John M Kaptein, Matthew J Kaptein
BACKGROUND: Wide ranges of sodium concentrations for different body fluid losses have been noted with minimal substantiating data and variability among sources, leading to use of "cumulative fluid balance" regardless of composition in hospitalized patients. AIMS: To define the sodium concentrations of fluid losses from the body. METHOD: We performed a systematic search and literature review in adult humans using PubMed database. RESULTS: Inclusion criteria were met for 107 full-text articles...
October 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27524917/how-do-patients-clinical-phenotype-and-the-physiological-mechanisms-of-the-operations-impact-the-choice-of-bariatric-procedure
#7
REVIEW
Thomas Bächler, Carel W le Roux, Marco Bueter
Bariatric surgery is currently the most effective option for the treatment of morbid obesity and its associated comorbidities. Recent clinical and experimental findings have challenged the role of mechanical restriction and caloric malabsorption as the main mechanisms for weight loss and health benefits. Instead, other mechanisms including increased levels of satiety gut hormones, altered gut microbiota, changes in bile acid metabolism, and/or energy expenditure have been proposed as explanations for benefits of bariatric surgery...
2016: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27252882/multicentre-prospective-survey-of-sehcat-provision-and-practice-in-the-uk
#8
Jennifer A Summers, Janet Peacock, Bolaji Coker, Viktoria McMillan, Mercy Ofuya, Cornelius Lewis, Stephen Keevil, Robert Logan, John McLaughlin, Fiona Reid
OBJECTIVE: A clinical diagnosis of bile acid malabsorption (BAM) can be confirmed using SeHCAT (tauroselcholic ((75)selenium) acid), a radiolabelled synthetic bile acid. However, while BAM can be the cause of chronic diarrhoea, it is often overlooked as a potential diagnosis. Therefore, we investigated the use of SeHCAT for diagnosis of BAM in UK hospitals. DESIGN: A multicentre survey was conducted capturing centre and patient-level information detailing patient care-pathways, clinical history, SeHCAT results, treatment with bile acid sequestrants (BAS), and follow-up in clinics...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27251913/the-holistic-management-of-consequences-of-cancer-treatment-by-a-gastrointestinal-and-nutrition-team-a-financially-viable-approach-to-an-enormous-problem
#9
Ann C Muls, Amyn Lalji, Christopher Marshall, Lewis Butler, Clare Shaw, Susan Vyoral, Kabir Mohammed, H Jervoise N Andreyev
There is no national NHS tariff to fund services for patients experiencing long-term bowel and nutritional problems after cancer treatment. In this paper, we report the clinical characteristics and outcomes of patients referred to our service and the estimated cost of a completed episode of care. Patient characteristics, symptom severity, investigations, diagnoses, number of clinic visits and referrals elsewhere were recorded in a prospective cohort study. During 2013-14, 325 patients completed assessment and treatment...
June 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27239296/recent-advances-in-metabolic-and-bariatric-surgery
#10
REVIEW
Vance L Albaugh, C Robb Flynn, Robyn A Tamboli, Naji N Abumrad
Obesity and its associated medical conditions continue to increase and add significant burden to patients, as well as health-care systems, worldwide. Bariatric surgery is the most effective treatment for severe obesity and its comorbidities, and resolution of diabetes is weight loss-independent in the case of some operations. Although these weight-independent effects are frequently described clinically, the mechanisms behind them are not well understood and remain an intense area of focus in the growing field of metabolic and bariatric surgery...
2016: F1000Research
https://www.readbyqxmd.com/read/27188621/-food-intolerances-caused-by-enzyme-defects-and-carbohydrate-malassimiliations-lactose-intolerance-and-co
#11
Christiane Schäfer
Apart from allergic conditions, carbohydrate malassimiliations (sugar metabolism disorders) are classified within the group of food intolerances. These dose-dependent, yet non-immunological reactions require gastroenterological or internal diagnosis following nutritional therapy. Intolerances to carbohydrates such as lactose (milk sugar) and fructose (fruit sugar) in addition to sugar alcohols (sorbitol, mannitol, lactitol etc.) have been gaining increasing attention in recent decades as they are the cause of a wide range of gastrointestinal symptoms...
June 2016: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27110372/measurement-of-serum-7%C3%AE-hydroxy-4-cholesten-3-one-as-a-marker-of-bile-acid-malabsorption-in-dogs-with-chronic-diarrhoea-a-pilot-study
#12
A C C Kent, G Cross, D R Taylor, R A Sherwood, P J Watson
Bile acid malabsorption is a common cause of chronic diarrhoea in people, however it has never previously been investigated in dogs, despite clinical suspicion of its existence. The goal of this study was to assess the feasibility of measuring serum 7α-hydroxy-4-cholesten-3-one (C4) in dogs, as a potential marker of bile acid malabsorption, and to see whether this is related to clinical disease severity or the presence of hypocobalaminaemia. Serum C4 concentration was measured in 20 clinically healthy control dogs and 17 dogs with chronic diarrhoea...
2016: Veterinary Record Open
https://www.readbyqxmd.com/read/27037739/short-bowel-syndrome-sbs-associated-alterations-within-the-gut-liver-axis-evolve-early-and-persist-long-term-in-the-piglet-model-of-short-bowel-syndrome
#13
Prue M Pereira-Fantini, Julie E Bines, Susan Lapthorne, Fiona Fouhy, Michelle Scurr, Paul D Cotter, Cormac Gm Gahan, Susan A Joyce
BACKGROUND AND AIM: Short bowel syndrome (SBS) is primarily characterized by malabsorption and malnutrition, resulting from loss of intestinal absorptive area following massive small bowel resection (SBR). Bile acids and the gut microbiota are functionally linked within the gut-liver axis; however, SBS-associated disturbances within the gut-liver axis remain largely unexplored. The aim of this study was to characterize the evolution of bile acid alterations within the gut-liver axis at both short-term and long-term time points and to relate these changes to alterations in colonic bacterial composition...
December 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/26891261/how-to-diagnose-and-treat-ibd-mimics-in-the-refractory-ibd-patient-who-does-not-have-ibd
#14
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
https://www.readbyqxmd.com/read/26886038/-gastrointestinal-causes-of-weight-loss-clinical-presentation-diagnostic-workup-and-therapy
#15
REVIEW
Sophie Fromhold-Treu, Georg Lamprecht
This review describes the gasterointestinal entities, their pathophysiology, clinical presentation, diagnostic workup and therapy that typically involve weight loss as the major presenting symptom. The differentiation of malassimilation into maldigestion and malabsorption is clinically mostly not helpful. Instead primary malasssimilation can be distinguished from secondary due to another disease. Celiac disease, lambliasis, small bowel CD, CVIDS and Whipple's disease result in loss of absorptive surface. Chronic intestinal pseudobstruction leads to weight loss through dysmotility and postprandial pain...
February 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/26832436/a-multicenter-prospective-study-to-investigate-the-diagnostic-accuracy-of-the-sehcat-test-in-measuring-bile-acid-malabsorption-research-protocol
#16
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
https://www.readbyqxmd.com/read/26645872/the-management-of-patients-with-enteric-hyperoxaluria
#17
REVIEW
John R Asplin
Enteric hyperoxaluria is a common occurrence in the setting of fat malabsorption, usually due to intestinal resection or intestinal bypass surgery. Enhanced intestinal absorption of dietary oxalate leads to elevated renal oxalate excretion, frequently in excess of 100 mg/d (1.14 mmol/d). Patients are at increased risk of urolithiasis and loss of kidney function from oxalate nephropathy. Fat malabsorption causes increased binding of diet calcium by free fatty acids, reducing the calcium available to precipitate diet oxalate...
February 2016: Urolithiasis
https://www.readbyqxmd.com/read/26627220/what-is-the-mechanism-behind-weight-loss-maintenance-with-gastric-bypass
#18
REVIEW
Saurav Chakravartty, Daniele Tassinari, Angelo Salerno, Emmanouil Giorgakis, Francesco Rubino
Obesity is an epidemic on the rise. With the failure of non-surgical strategies, bariatric surgery has emerged as the most effective therapeutic option for the treatment of severe obesity. Among various surgical options, Roux-en-Y gastric bypass (RYGB) results in sustained weight loss and profound metabolic improvements. The traditional view that gastric bypass and bariatric surgery in general works primarily through restriction/malabsorption of nutrients has become obsolete. It is now increasingly recognised that its mechanisms of action are primarily physiologic, not mechanic...
June 2015: Current Obesity Reports
https://www.readbyqxmd.com/read/26621941/management-of-bile-acid-malabsorption-using-low-fat-dietary-interventions-a-useful-strategy-applicable-to-some-patients-with-diarrhoea-predominant-irritable-bowel-syndrome
#19
Lorraine Watson, Amyn Lalji, Shankar Bodla, Ann Muls, H Jervoise N Andreyev, Clare Shaw
This study evaluates the efficacy of low-fat dietary interventions in the management of gastrointestinal (GI) symptoms due to bile acid malabsorption. In total, 40 patients with GI symptoms and a 7-day (75)selenium homocholic acid taurine (SeHCAT) scan result of <20%, were prospectively recruited and then advised regarding a low-fat dietary intervention. Before and after dietary intervention, patients rated their GI symptoms using a 10-point numerical scale, and recorded their intake in 7-day dietary diaries...
December 2015: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/26525925/food-fibre-bile-acids-and-the-pelvic-floor-an-integrated-low-risk-low-cost-approach-to-managing-irritable-bowel-syndrome
#20
REVIEW
Hamish Philpott, Sanjay Nandurkar, John Lubel, Peter R Gibson
Patients presenting with abdominal pain and diarrhea are often labelled as suffering from irritable bowel syndrome, and medications may be used often without success. Advances in the understanding of the causes of the symptoms (including pelvic floor weakness and incontinence, bile salt malabsorption and food intolerance) mean that effective, safe and well tolerated treatments are now available.
October 28, 2015: World Journal of Gastroenterology: WJG
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