Document Detail


Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome.
MedLine Citation:
PMID:  19570102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recurrent, watery diarrhoea affects one-third of patients diagnosed with irritable bowel syndrome ('IBS-D'). Idiopathic bile acid malabsorption ('I-BAM') may be the cause. AIM: To determine the prevalence of I-BAM in patients suffering from IBS-D. METHODS: A systematic search was performed of publications reporting patients presenting with IBS-D type symptoms, who were subsequently confirmed as having I-BAM by SeHCAT scanning. RESULTS: Eighteen relevant studies, 15 prospective, comprising 1223 patients were identified. Five studies (429 patients) indicated that 10% (CI: 7-13) patients had severe bile acid malabsorption (SeHCAT 7 day retention <5% of baseline value). 17 studies (1073 patients) indicated that 32% (CI: 29-35) patients had moderate bile acid malabsorption (SeHCAT <10%). 7 studies (618 patients) indicated that 26% (CI: 23-30) patients had mild (SeHCAT <15%) bile acid malabsorption. Pooled data from 15 studies showed a dose-response relationship according to severity of malabsorption to treatment with a bile acid binder: response to colestyramine occurred in 96% of patients with <5% retention, 80% at <10% retention and 70% at <15% retention. CONCLUSIONS: Idiopathic adult-onset bile acid malabsorption is not rare. International guidelines for the management of irritable bowel syndrome need to be revised so that clinicians become more aware of this possibility.
Authors:
L Wedlake; R A'Hern; D Russell; K Thomas; J R F Walters; H J N Andreyev
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-06-30
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  30     ISSN:  1365-2036     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-08     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  707-17     Citation Subset:  IM    
Affiliation:
Department of Nutrition & Dietetics, The Royal Marsden Hospital, London and Sutton, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Anion Exchange Resins / therapeutic use*
Bile Acids and Salts / metabolism*
Cholestyramine Resin / therapeutic use*
Diarrhea / epidemiology,  etiology*
Dose-Response Relationship, Drug
Humans
Irritable Bowel Syndrome / complications,  epidemiology,  physiopathology*
Malabsorption Syndromes / complications*,  drug therapy,  epidemiology
Prevalence
Prospective Studies
Retrospective Studies
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Anion Exchange Resins; 0/Bile Acids and Salts; 11041-12-6/Cholestyramine Resin
Comments/Corrections
Comment In:
Aliment Pharmacol Ther. 2010 Jan;31(1):161-2; author reply 162-4   [PMID:  20002031 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The Plasmodium falciparum protein Pfg27 is dispensable for gametocyte and gamete production, but con...
Next Document:  When can we distinguish between neutral and non-neutral processes in community dynamics under ecolog...