Journal
AMERICAN JOURNAL OF MEDICINE
Volume 125, Issue 6, Pages 538-544Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2011.11.006
Keywords
Bile acid malabsorption; Disaccharidase deficiency; Functional diarrhea; Glucosidase deficiency; Glucosidase inhibition; Irritable bowel syndrome; Maldigestion; Pancreatic insufficiency; Postprandial diarrhea; Trigger foods
Categories
Ask authors/readers for more resources
Unexpected, urgent, sometimes painful bowel movements after eating are common complaints among adults. Without a clear etiology, if pain is present and resolves with the movements, this is usually labeled irritable bowel syndrome-diarrhea based solely on symptoms. If this symptom-based approach is applied exclusively, it may lead physicians not to consider treatable conditions: celiac disease, or maldigestion due to bile acid malabsorption, pancreatic exocrine insufficiency, or an a-glucosidase (sucrase, glucoamylase, maltase, or isomaltase) deficiency. These conditions can be misdiagnosed as irritable bowel syndrome-diarrhea (or functional diarrhea, if pain is not present). Limited testing is currently available to confirm these conditions (antibody screens for celiac disease; fecal fat as a surrogate marker for pancreatic function). Therefore, empirical treatment with alpha amylase, pancreatic enzymes, or a bile acid-binding agent may simultaneously treat these patients and serve as a surrogate diagnostic test. This review will summarize the current evidence for bile acid malabsorption, and deficiencies of pancreatic enzymes or a-glucosidases as potential causes for postprandial diarrhea, and provide an algorithm for treatment options. (C) 2012 Elsevier Inc. All rights reserved. . The American Journal of Medicine (2012) 125, 538-544
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available