China
Africa
Explore chapters and articles related to this topic
Nuclear Medicine Imaging and Therapy
Published in Debbie Peet, Emma Chung, Practical Medical Physics, 2021
David Towey, Lisa Rowley, Debbie Peet
Bile acid malabsorption is a chronic condition that affects a patient’s digestive system. The process can be measured using a SeHCAT study. SeHCAT (23-seleno-25-homotaurocholic acid, selenium homocholic acid taurine, or tauroselcholic acid) is a drug used to diagnose bile acid malabsorption. The patient is given a low activity 75Se capsule to swallow. The capsule is broken down in the digestive system, and the radiopharmaceutical is actively absorbed by the intestines and re-excreted by the bile duct. Over 7 days, the pharmaceutical is expected to pass around this loop around 35 times, and if malabsorption is present, the level of SeHCAT within the patient will reduce considerably. The amount of SeHCAT in the patient is measured at 4 hours post-administration and again 1 week later.
Functional abdominal disorders
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Bernard Coulie, Michael Camilleri
Bile acid sequestrian may relieve the choleric effect of bile acids in patients who have idiopathic bile acid malabsorption.136 Cholestyramine, however, is considered as a second-line treatment in IBS with predominant diarrhea. The rationale is based on the documentation of bile acid malabsorption in patients with functional diarrhea that mimics IBS with diarrhea.137,138 The simpler, often more acceptable approach in patients who find cholestyramine distasteful or in whom bile acid sequestrates are contraindicated, is to use loperamide as the first intervention for bile acid malabsorption.
Restorative Proctocolectomy in Colitis
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Colin Peirce, Feza Remzi, Michael R.B. Keighley
Villous atrophy and colonic metaplasia with bacterial overgrowth in the pouch is a well-recognised consequence of pouch construction and is often associated with a chronic inflammatory infiltrate. However, there does not appear to be any evidence for serious metabolic sequelae as a result. Bile acid malabsorption has been reported with increased faecal bile acid excretion.113 Total or low-density serum lipoprotein levels as well as triglycerites were low in pouch patients. Lactose malabsorption has been reported in a small proportion of patients in pouch surgery.
Consideration of quality of life in the treatment decision-making for patients with advanced gastroenteropancreatic neuroendocrine tumors
Published in Expert Review of Anticancer Therapy, 2023
Boris G. Naraev, Josh Mailman, Thorvardur R. Halfdanarson, Heloisa P. Soares, Erik S. Mittra, Julie Hallet
NET-related diarrhea is one of the most common and impactful symptoms affecting patient QoL [24,62]. There are several symptomatic treatments depending on the underlying pathophysiology: carcinoid syndrome, steatorrhea, short GI transit time, or excessive bile acids. For diarrhea due to carcinoid syndrome, SSA therapy is beneficial [72]. However, some patients with serotonin-producing tumors experience diarrhea that is inadequately controlled by SSAs. In these patients, telotristat ethyl should be considered as add-on therapy based on results from TELESTAR. Patients with poorly controlled diarrhea due to carcinoid syndrome may also benefit from RLT. Chronic SSA use may cause pancreatic insufficiency and steatorrhea [62,73], which can be addressed with pancreatic enzyme therapy and dietary adjustments. Additionally, patients with NETs who have undergone small bowel resection can develop diarrhea resulting from shortened GI transit time or decreased bile acid resorption [74]. Diarrhea resulting from short GI transit time can be improved with dietary adjustments, adjustment of fluid consumption, and certain medications. Bile acid sequestrants can address bile acid malabsorption. More generally, nutritional assessments and dietary modifications have the potential to improve patient symptoms (including but not limited to diarrhea) and QoL [75].
Mechanism of Asbt (Slc10a2)-related bile acid malabsorption in diarrhea after pelvic radiation
Published in International Journal of Radiation Biology, 2020
Lina Wang, Yan Zhou, Xiaohu Wang, Guangwen Zhang, Bin Guo, Xiaoming Hou, Juntao Ran, Qiuning Zhang, Chengcheng Li, Xueshan Zhao, Yichao Geng, Shuangwu Feng
Bile acid malabsorption (BAM) has been reported as one of the major causes of diarrhea (Sullivan 1962; Barkun et al. 2013). Enterohepatic circulation (EHC) is a vital mechanism by which bile acids (BAs) are synthesized in the liver and excreted into the intestinal tract; then, 95% of BAs are reabsorbed into the blood by the intestine and from there, they move back to the liver via the portal vein (Ferrebee and Dawson 2015). Therefore, reabsorption of BAs by the bowel plays a significant role in sustaining BA homeostasis. Several BAs can cause poor fat absorption and lead to fatty diarrhea, increase the frequency of colon peristalsis, and inhibit the absorption of Na+ and water in the intestine when the reuptake of BAs is disordered (Camilleri 2014). It was reported that pelvic radiotherapy could cause diarrhea in over 50% of patients due to the malabsorption of BAs (Phillips et al. 2015). In addition, bile absorption in the ileum was decreased after exposure of the abdomen to X-irradiation in rats (Sullivan 1965), causing accumulation of bile salts in the small intestine of the rats and leading to acute RE after a single radiation dose of 11 Gy (Delaney and Bonsack 1992). These studies indicate that BAM may play a vital function in diarrhea induced by pelvic radiation.
Advancements in drug development for diarrhea-predominant irritable bowel syndrome
Published in Expert Opinion on Investigational Drugs, 2018
Giovanni Dothel, Maria Raffaella Barbaro, Emanuel Raschi, Giovanni Barbara, Fabrizio De Ponti
Since currently IBS is subclassified according to the predominant bowel habit, there have been efforts to identify patients’ subgroups based on the aforementioned pathophysiological subgroups [19]. There are some examples indicating that the identification of subgroups according to pathophysiological features might bring tangible advantages for personalized managements. Bile acid malabsorption in patients with IBS-D predicts the response to bile acid binder [20]. Also, taxa enrichment in gut microbiota of IBS was linked to a response to a low-fermentable oligo-,di-,mono-saccharides and polyols (FODMAP) diet [21]. Finally, low-grade immune activation predicted the response to mesalazine in the subgroup of IBS patients developing symptoms after infection (i.e. post-infection IBS [22]).