Bile Salt Enteropathy. Luminal bile acids play a controversial role in the damage produced by these drugs. Bile acids BAs are secreted into the gut where they play a crucial role in the emulsification of dietary lipids that facilitates their absorption.
The pathophysiological mechanism driving CVID enteropathy is not known but pathological alterations to the microbiota dysbiosis could be a key factor. The usually effective enterohepatic circulation of bile salts is most obviously deranged in ileal disease. Cholerheic enteropathy a syndrome of diarrhea due to the effects of excessive bile salts in the colon occurs when bile salt absorption from the terminal ileum is impaired.
Bile salt induced diarrhoea.
It can result from malabsorption secondary to gastrointestinal disease or be a primary disorder associated with excessive bile. Diarrhea associated with a stool osmolal gap less than 50 mOsmkg. Diarrhea that develops after cholecystectomy may be due to increased amounts of bile acids presented to the large bowel a cholerheic enteropathy We have studied eight patients to determine the cause for chronic diarrhea after cholecystectomy and found no abnormality other than elevated bile acids in the stool of six of them. Physicians should suspect collagenous and lymphocytic colitis in middle-aged patients presenting.
