New insights into bile acid malabsorption

被引：31

作者：

Johnston I. ^{[1
,2
]}

Nolan J. ^{[1
,2
]}

Pattni S.S. ^{[1
,2
]}

Walters J.R.F. ^{[1
,2
]}

机构：

[1] Section of Hepatology and Gastroenterology, Department of Medicine, Imperial College London, London W12 0HS, Du Cane Road

[2] Imperial College Healthcare, Hammersmith Hospital, London W12 0HS, Du Cane Road

来源：

Current Gastroenterology Reports | 2011年 / 13卷 / 5期

关键词：

7α-hydroxy-4-cholesten-3-one; Bile acid malabsorption; Bile acid synthesis; Chronic diarrhea; CYP7A1; Fibroblast growth; Irritable bowel syndrome; SeHCAT;

D O I：

10.1007/s11894-011-0219-3

中图分类号：

学科分类号：

摘要：

Bile acid malabsorption occurs when there is impaired absorption of bile acids in the terminal ileum, so interrupting the normal enterohepatic circulation. The excess bile acids in the colon cause diarrhea, and treatment with bile acid sequestrants is beneficial. The condition can be diagnosed with difficulty by measuring fecal bile acids, or more easily by retention of selenohomocholyltaurine (SeHCAT), where this is available. Chronic diarrhea caused by primary bile acid diarrhea appears to be common, but is under-recognized where SeHCAT testing is not performed. Measuring excessive bile acid synthesis with 7α-hydroxy-4-cholesten-3-one may be an alternative means of diagnosis. It appears that there is no absorption defect in primary bile acid diarrhea but, instead, an overproduction of bile acids. Fibroblast growth factor 19 (FGF19) inhibits hepatic bile acid synthesis. Defective production of FGF19 from the ileum may be the cause of primary bile acid diarrhea. © Springer Science+Business Media, LLC 2011.

引用

页码：418 / 425

页数：7

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