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Colonic bile acid exposure influenced IBS symptoms
05/22/14 04:50 PM

Colonic bile acid exposure influenced IBS symptoms, therapy
Bajor A. Gut. 2014;doi:10.1136/gutjnl-2013-305965.

ay 15, 2014

Patients with irritable bowel syndrome, primarily those who were nonconstipated, had elevated levels of colonic bile acid that was indicative of abnormal 75Se-labeled homocholic acid-taurine retention and high 7 alpha-hydroxy-4-cholesten-3-one serum levels in a recent study.
Swedish researchers enrolled 141 patients (mean age, 35.3 years; 72.3% women) with irritable bowel syndrome (IBS), who were subclassified as IBS-diarrhea predominant (IBS-D; n=65), IBS-constipation predominant (IBS-C; n=26) and alternating IBS (IBS-A; n=50). They measured patients for 75Se-labeled homocholic acid-taurine (75SeHCAT) retention, serum levels of 7 alpha-hydroxy-4-cholesten-3-one (C4) and fibroblast growth factor (FGF19).

The IBS cohort had lower 75SeHCAT retention values (28 19% vs. 39 18%; P=.005) at 7 days than 29 healthy controls without GI symptoms, and IBS patients displayed greater levels of C4c than controls (n=435) when adjusted for cholesterol (P<.001). FGF19 was considered similar.

Eighteen percent of IBS patients demonstrated abnormal 75SeHCAT retention (<10%), and 30 of 133 evaluable patients had high C4c values. Those with abnormal 75SeHCAT retention had more frequent stools (2.9 vs. 2.1 stools/daily; P=.01), greater BMI (26 vs. 23.1 kg/m2; P=.002), accelerated colonic transmit time (0.9 vs. 1.9 days; P=.007), rectal hyposensitivity (48.7 vs. 38.9 mm Hg; P=.008) and C4c values (11.5 vs. 3.7 mg/mol; P=.02), and lower FGF19 levels (99.2 vs. 149.7 pg/mL; P=.002) than IBS patients with 75SeHCAT retention greater than 10%.

IBS patients (n=27) treated with colestipol for up to 8 weeks showed improved IBS Severity Severity Scoring System grades (P<.01), including 15 patients who met treatment response criteria of at least 50% adequate relief of weeks 5 through 8.

Our findings strengthen the involvement of increased bile acid exposure in the colon as a partial mechanism for symptom generation in patients with especially nonconstipated IBS, that is, IBS-D and IBS-A, the researchers concluded. The positive symptomatic response to open label treatment with bile acid binders in patients with IBS with low 75SeHCAT values supports a role of bile acids in IBS symptomatology, but placebo-controlled studies are warranted.

http://www.healio.com/gastroenterology/irritable-bowel-syndrome/news/online/%7B46b70fe3-d645-48bf-b29b-899c7f150fab%7D/colonic-bile-acid-exposure-influenced-ibs-symptoms-therapy

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Heather is the Administrator of the IBS Message Boards. Shes the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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. * New Syndrome Connects Gallbladder Dysfunction And Chronic Diarrhea HeatherAdministrator 03/09/04 11:45 AM
. * Researchers Pioneer Accessible, Cost-Effective Treatments for IBS HeatherAdministrator 03/08/04 06:48 PM
. * Splitting IBS: from original Rome to Rome II criteria HeatherAdministrator 02/10/04 02:35 PM
. * Utilization patterns and net direct medical cost to Medicaid of IBS HeatherAdministrator 02/10/04 02:34 PM
. * Family practitioners' attitudes and knowledge about IBS HeatherAdministrator 02/10/04 02:32 PM
. * The Effect of Somatization on Gastrointestinal and Extraintestinal Symptoms of IBS HeatherAdministrator 01/26/04 03:26 PM
. * Surgery and IBS HeatherAdministrator 01/26/04 03:21 PM
. * IBS Subgroups by Bowel Habit Predominance HeatherAdministrator 01/26/04 03:13 PM
. * Visceral perception thresholds in irritable bowel syndrome HeatherAdministrator 01/07/04 11:56 AM
. * Electric activity of the colon in irritable bowel syndrome HeatherAdministrator 01/07/04 11:52 AM
. * Irritable Bowel Syndrome's Possible Genetic Link HeatherAdministrator 01/07/04 11:40 AM
. * Intestinal gas distribution determines abdominal symptoms HeatherAdministrator 12/16/03 12:27 PM
. * Faecal incontinence - Many treatment options now exist HeatherAdministrator 12/16/03 12:17 PM
. * Abnormal Colonic Propagated Activity in Patients with Constipation HeatherAdministrator 12/16/03 12:07 PM
. * Colonic Propulsive Impairment in Intractable Slow-Transit Constipation HeatherAdministrator 12/16/03 12:03 PM
. * Overlapping upper and lower GI symptoms in IBS patients with constipation or diarrhea HeatherAdministrator 12/01/03 05:51 PM
. * Familial aggregation of irritable bowel syndrome HeatherAdministrator 12/01/03 05:49 PM
. * Outlook affects bowel disorder patients HeatherAdministrator 11/18/03 03:30 PM
. * Doctors unmoved by bowel misery HeatherAdministrator 11/18/03 03:28 PM
. * Travelers' Diarrhoea Can Trigger Irritable Bowel HeatherAdministrator 11/04/03 03:21 PM
. * Mind-Body Technique Eases Kids' Gut Pain HeatherAdministrator 10/30/03 11:17 AM
. * Molecular Alterations In Patients With Irritable Bowel Syndrome HeatherAdministrator 10/20/03 03:46 PM
. * Three in Four People With IBS Also Have Functional Dyspepsia HeatherAdministrator 10/15/03 03:28 PM
. * Infectious Gastroenteritis Linked to Irritable Bowel Syndrome HeatherAdministrator 09/30/03 02:27 PM
. * Association Between Pain Episodes & High Amplitude Pressure Waves in IBS HeatherAdministrator 09/16/03 03:54 PM
. * Constipation and its management HeatherAdministrator 09/16/03 03:41 PM
. * Contributions of suggestion, desire, and expectation to placebo effects in IBS patients HeatherAdministrator 09/16/03 03:28 PM
. * Do published guidelines for evaluation of IBS reflect practice? HeatherAdministrator 08/30/03 02:40 PM
. * Cognitive-behavioral therapy versus education and desipramine versus placebo for IBS HeatherAdministrator 08/12/03 12:54 PM
. * Distinctive features of postinfective irritable bowel syndrome HeatherAdministrator 07/28/03 03:18 PM
. * UCLA/CURE Neuroenteric Disease Program Newsletter HeatherAdministrator 07/23/03 10:38 AM
. * Bacterial Overgrowth in IBS HeatherAdministrator 07/18/03 12:15 PM
. * Diagnosis of irritable bowel syndrome. HeatherAdministrator 07/18/03 11:54 AM
. * Eradication of small intestinal bacterial overgrowth reduces symptoms of IBS HeatherAdministrator 07/18/03 11:44 AM
. * Antibiotics increase functional abdominal symptoms. HeatherAdministrator 07/18/03 11:41 AM
. * Treatment of the irritable bowel syndrome. HeatherAdministrator 07/15/03 11:02 PM
. * Extraintestinal symptoms in IBS and IBD HeatherAdministrator 07/15/03 06:21 PM
. * Postinfectious irritable bowel syndrome. HeatherAdministrator 07/15/03 06:19 PM
. * Dieting severity and GI symptoms in college women. HeatherAdministrator 07/15/03 01:13 PM
. * Functional GI disorders and eating disorders - Relevance of the association HeatherAdministrator 07/15/03 11:14 AM
. * Features of eating disorders in patients with IBS HeatherAdministrator 07/15/03 11:12 AM
. * New and Important Insights Into IBS HeatherAdministrator 07/14/03 03:24 PM
. * The Irritable Bowel Syndrome-Fibromyalgia Connection HeatherAdministrator 07/14/03 03:19 PM
. * Update on Treatment of Functional Gastrointestinal Disorders HeatherAdministrator 07/14/03 02:55 PM
. * Irritable bowel syndrome in primary care: The patients and doctors views HeatherAdministrator 07/14/03 02:43 PM
. * Inflammatory bowel disease and irritable bowel syndrome: separate or unified? HeatherAdministrator 07/14/03 02:32 PM

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