Article
Gastroenterology & Hepatology
Virginia Flores, Helena Martinez-Lozano, Federico Bighelli, Javier Orcajo, Javier Garcia-Lledo, Juan Carlos Alonso-Farto, Luis Menchen
Summary: Bile acid malabsorption is common in patients with chronic diarrhoea of functional characteristics, and systematic investigation should be included in the diagnostic algorithms for patients with chronic watery diarrhoea. Clinical response to cholestyramine varies among patients with bile acid diarrhoea, and there are no clear predictors of response to treatment.
BMC GASTROENTEROLOGY
(2021)
Review
Nutrition & Dietetics
Yvonne A. McKenzie, Jana Sremanakova, Chris Todd, Sorrel Burden
Summary: Currently, there is insufficient evidence to support the effectiveness of diet, psychological, or exercise therapies for diarrhea, abdominal pain, and flatulence in adults with BAD. High-quality randomized controlled trials are needed.
JOURNAL OF HUMAN NUTRITION AND DIETETICS
(2022)
Article
Oncology
Caroline Gee, Catherine Fleuret, Ana Wilson, Daniel Levine, Ramy Elhusseiny, Ann Muls, David Cunningham, Darina Kohoutova
Summary: Bile acid malabsorption is a common condition in cancer patients, but treatments are highly effective.
Article
Toxicology
Jingxuan Wang, Bas Sijs, Wouter Bakker, Laura de Haan, Hans Bouwmeester
Summary: The trichothecene toxin deoxynivalenol (DON) contaminates cereal-based food and inhibits protein translation. DON activates stress mitogen-activated protein kinases (MAPK), leading to pro-inflammatory cytokine production. DON also decreases bile acid reabsorption and apical sodium-dependent bile acid transporter (ASBT) expression. The study suggests that DON-induced bile acid malabsorption is regulated by MAPK activation-induced pro-inflammatory cytokine production and protein synthesis inhibition.
TOXICOLOGY LETTERS
(2023)
Review
Medicine, General & Internal
Giovanni Marasco, Cesare Cremon, Maria Raffaella Barbaro, Francesca Falangone, Davide Montanari, Federica Capuani, Giada Mastel, Vincenzo Stanghellini, Giovanni Barbara
Summary: Bile acid malabsorption (BAM) is a common cause of chronic diarrhea, but its prevalence is not well studied. Bile acid diarrhea (BAD) occurs due to dysregulation of the enterohepatic recirculation of bile acids. The gold standard for diagnosing and assessing the severity of BAD is currently the selenium homotaurocholic acid test, but other serum markers are being validated for clinical use. The first-line treatment for BAD is bile acid sequestrants, but further diagnostics are needed for patients who do not respond to this treatment. Early and accurate diagnosis of BAD can improve patients' quality of life and reduce the burden on healthcare systems. More research is needed to explore alternative therapeutic approaches for BAD, such as gut microbiota modulating therapies.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Food Science & Technology
Celia Costas, M. Carmen Louzao, Sandra Raposo-Garcia, Carmen Vale, Mercedes R. Vieytes, Luis M. Botana
Summary: In this study, the researchers evaluated the effect of Okadaic acid (OA) on diarrhea using mice models. The results showed that OA exposure led to an increase in chloride and sodium concentration in the feces, indicating a secretory diarrhea. However, pre-treatment with cyproheptadine (CPH) attenuated the damage caused by OA in the colon and jejunum. The study identified cellular mechanisms underlying OA-induced diarrhea and highlighted the complex toxicity of this compound.
FOOD AND CHEMICAL TOXICOLOGY
(2022)
Article
Gastroenterology & Hepatology
Martin L. Karhus, Andreas Bronden, Julie L. Forman, Anne Haaber, Elisabeth Knudsen, Ebbe Langholz, Lars O. Dragsted, Svend H. Hansen, Martin Krakauer, Tina Vilsboll, David P. Sonne, Filip K. Knop
Summary: Liraglutide showed superiority over colesevelam in reducing stool frequency for patients with bile acid diarrhoea, indicating its potential as a new treatment modality.
LANCET GASTROENTEROLOGY & HEPATOLOGY
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Alexander Smout, James Scuffham, Paul Hinton
Summary: The study evaluated the feasibility of replacing baseline images with a predictive model based on height and weight, which showed a strong correlation with measured counts. When using predicted baseline counts, almost all patients had no change in severity grading, indicating the potential practical application of the model.
NUCLEAR MEDICINE COMMUNICATIONS
(2021)
Review
Medicine, General & Internal
Alexia Farrugia, Joseph Anthony Attard, Saboor Khan, Nigel Williams, Ramesh Arasaradnam
Summary: This systematic review investigated the rate and predictive factors of postcholecystectomy diarrhea (PCD). The review found that PCD is relatively common, affecting 13.3% of patients. However, there is no consensus on the predictive factors for PCD. Early investigation for bile acid diarrhea in suspected PCD is recommended. More studies are needed to determine the possible predictive factors for PCD.
Article
Gastroenterology & Hepatology
S. Coughlan, A. Das, E. O'Herlihy, F. Shanahan, P. W. O'Toole, I. B. Jeffery
Summary: The study conducted metagenomic sequencing of fecal Virus-Like Particles (VLPs) from 55 patients with IBS and 51 control individuals. It found significantly lower alpha diversity of viral clusters in IBS, identified core viromes in both IBS and control groups, and noted no significant covariation between the virome and the bacteriome, IBS clinical subtype, or Bile Acid Malabsorption status.
Review
Gastroenterology & Hepatology
Rachel A. Khaw, Edward J. Nevins, Alexander W. Phillips
Summary: This study evaluated the occurrence and management of malabsorption syndromes after esophagectomy, finding that these syndromes are often unrecognized and underreported. Patients may experience gastrointestinal symptoms that have a negative impact on post-operative quality of life. While treatment modalities exist to alleviate symptoms, further understanding of these conditions, their diagnosis, and management is necessary.
JOURNAL OF GASTROINTESTINAL SURGERY
(2022)
Article
Microbiology
Aditi Kumar, Mohammed Nabil Quraishi, Hafid O. Al-Hassi, Mohammed E. El-Asrag, Jonathan P. Segal, Manushri Jain, Helen Steed, Jeffrey Butterworth, Adam Farmer, John Mclaughlin, Andrew Beggs, Matthew J. Brookes
Summary: This study aimed to characterize the microbiome in different cohorts of patients with bile acid diarrhea (BAD) and determine if treatment with the bile acid sequestrant colesevelam could alter the microbiome. The study found that BAD patients had reduced microbiome diversity, but patients who responded to colesevelam treatment had increased abundance of certain bacteria. This is the first study to examine the treatment effects on the microbiome in BAD, suggesting a possible association between colesevelam and the microbiome through bile acid modulation in clinical responders.
FRONTIERS IN MICROBIOLOGY
(2023)
Article
Gastroenterology & Hepatology
Martin Storr, Manfred Gross, Ahmed Madisch, Ulrike von Arnim, Hubert Moennikes, Julian Walters, Heiner Krammer, Jutta Keller
Summary: Bile acid diarrhea is a commonly overlooked cause of chronic diarrhea, affecting up to 5% of individuals even after exclusion of other causes. Diagnosis of bile acid diarrhea follows a clear algorithm, with treatment typically involving medications and vitamin supplementation.
ZEITSCHRIFT FUR GASTROENTEROLOGIE
(2021)
Review
Medicine, Research & Experimental
Zhen-Ning Lu, Hong-Wei He, Na Zhang
Summary: This review discusses the expression characteristics, important roles in bile acid homeostasis, and regulatory mechanisms of OSTα-OSTβ. Studies show that multiple nuclear receptors and cytokines can be involved in regulating OSTα-OSTβ. Therapeutic strategies targeting OSTα-OSTβ are essential for correcting abnormal bile acid levels and intervening in the progression of diseases related to bile acid homeostasis disruption.
Article
Gastroenterology & Hepatology
Wei Wei, Huifen Wang, Yanli Zhang, Yu Zhang, Bingyu Niu, Shuo Chen, Wenxue Zhang, Shukun Yao
Summary: The expression levels of TGR5 in colonic mucosa were significantly higher in IBS-D patients compared to controls, while VDR levels showed no significant difference. Patients with more severe or frequent abdominal pain had higher levels of TGR5. Primary BAs in feces were increased in IBS-D patients and correlated with the severity of diarrhea. The level of TGR5 was positively associated with primary BAs and negatively associated with secondary BAs in participants providing both mucosal and stool samples.
DIGESTIVE AND LIVER DISEASE
(2021)
Editorial Material
Gastroenterology & Hepatology
Julian R. F. Walters
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2020)
Article
Endocrinology & Metabolism
Emma Rose McGlone, Khalefah Malallah, Joyceline Cuenco, Nicolai J. Wewer Albrechtsen, Jens J. Holst, Royce P. Vincent, Charlotte Ling, Omar A. Khan, Surabhi Verma, Ahmed R. Ahmed, Julian R. F. Walters, Bernard Khoo, Stephen R. Bloom, Tricia M. M. Tan
Summary: The study found that CDCA and UDCA have differential effects on gut hormone secretion, with CDCA increasing GLP-1 and OXM secretion while reducing GIP secretion. CDCA also increased fasting GLP-1 and OXM levels along with insulin secretion, while reducing postprandial GIP secretion and insulin levels. On the other hand, UDCA did not affect gut hormone secretion. These findings suggest that CDCA may have beneficial effects on patients with obesity and diabetes.
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM
(2021)
Article
Multidisciplinary Sciences
Nidhi M. Sagar, Henri Duboc, Gemma L. Kay, Mohammad T. Alam, Alfian N. Wicaksono, James A. Covington, Christopher Quince, Margarita Kokkorou, Vaios Svolos, Lola J. Palmieri, Konstantinos Gerasimidis, Julian R. F. Walters, Ramesh P. Arasaradnam
SCIENTIFIC REPORTS
(2020)
Article
Obstetrics & Gynecology
A. L. Mitchell, C. Ovadia, A. Syngelaki, K. Souretis, M. Martineau, J. Girling, T. Vasavan, H. M. Fan, P. T. Seed, J. Chambers, J. R. F. Walters, K. Nicolaides, C. Williamson
Summary: Non-fasting bile acids can improve the diagnostic accuracy of intrahepatic cholestasis of pregnancy (ICP) diagnosis, with variations in non-fasting TSBA reference ranges among different ethnicities.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2021)
Article
Gastroenterology & Hepatology
Martin Storr, Manfred Gross, Ahmed Madisch, Ulrike von Arnim, Hubert Moennikes, Julian Walters, Heiner Krammer, Jutta Keller
Summary: Bile acid diarrhea is a commonly overlooked cause of chronic diarrhea, affecting up to 5% of individuals even after exclusion of other causes. Diagnosis of bile acid diarrhea follows a clear algorithm, with treatment typically involving medications and vitamin supplementation.
ZEITSCHRIFT FUR GASTROENTEROLOGIE
(2021)
Article
Medicine, General & Internal
George E. Hiner, Julian R. F. Walters
Summary: Chronic diarrhea can be a common symptom of various diseases or a long-lasting disorder, requiring thorough history taking and tests such as blood and fecal screening, as well as exclusion of inflammatory bowel disease and colorectal neoplasia. Specific therapy is available for common conditions like coeliac disease, microscopic colitis, and bile acid diarrhea.
Editorial Material
Gastroenterology & Hepatology
Julian R. F. Walters
Summary: Recent findings suggest that a large proportion of IBS-D patients have increased faecal bile acids, including primary bile acids, indicating changes in bacterial metabolism. The expression of the colonic membrane bile acid receptor TGR5 is associated with faecal bile acids and the severity of symptoms.
DIGESTIVE AND LIVER DISEASE
(2021)
Letter
Gastroenterology & Hepatology
Sara Balesaria, Sanjeev S. Pattni, Ian M. Johnston, Jonathan D. Nolan, Richard N. Appleby, Julian R. F. Walters
Review
Gastroenterology & Hepatology
Edoardo Savarino, Fabiana Zingone, Brigida Barberio, Giovanni Marasco, Filiz Akyuz, Hale Akpinar, Oana Barboi, Giorgia Bodini, Serhat Bor, Giuseppe Chiarioni, Gheorghe Cristian, Maura Corsetti, Antonio Di Sabatino, Anca Mirela Dimitriu, Vasile Drug, Dan L. Dumitrascu, Alexander C. Ford, Goran Hauser, Radislav Nakov, Nisha Patel, Daniel Pohl, Catalin Sfarti, Jordi Serra, Magnus Simren, Alina Suciu, Jan Tack, Murat Toruner, Julian Walters, Cesare Cremon, Giovanni Barbara
Summary: This article summarizes the current state of consensus on the definition, diagnosis, and management of irritable bowel syndrome with diarrhoea (IBS-D) and functional diarrhoea (FDr). Through literature summary and voting, European experts reached a consensus on 31 statements and provided guidance on diagnosis and treatment.
UNITED EUROPEAN GASTROENTEROLOGY JOURNAL
(2022)
Editorial Material
Gastroenterology & Hepatology
Julian R. F. Walters
LANCET GASTROENTEROLOGY & HEPATOLOGY
(2022)
Article
Gastroenterology & Hepatology
Benjamin H. Mullish, Laura Martinez-Gili, Elena Chekmeneva, Goncalo D. S. Correia, Matthew R. Lewis, Verena Horneffer-Van Der Sluis, Lauren A. Roberts, Julie A. K. McDonald, Alexandros Pechlivanis, Julian R. F. Walters, Emma L. McClure, Julian R. Marchesi, Jessica R. Allegretti
Summary: This study aimed to explore the dynamics of fecal bile acids (BAs) in patients with primary Clostridioides difficile infection (CDI) and investigate their potential for predicting recurrence. The results showed that gut BA metabolism dynamics differed between patients with and without recurrence, suggesting that individual BAs may serve as novel biomarkers for predicting CDI recurrence.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2022)
Meeting Abstract
Gastroenterology & Hepatology
Lukas M. Balsiger, Filiz Akyuz, Brigida Barberio, Serhat Bor, Giuseppe Chiarioni, Maura Corsetti, Cesare Cremon, Antonio Di Sabatino, Vasile Drug, Dan Lucian Dumitrascu, Goran Hauser, Daniel Pohl, Karlien Raymenants, Emidio Scarpellini, Jolien Schol, Jordi Serra, Magnus Simren, Murat Toruner, Tim Vanuytsel, Julian R. Walters, Fabiana Zingone, Edoardo V. Savarino, Jan F. Track
Meeting Abstract
Gastroenterology & Hepatology
Julian Walters
Article
Gastroenterology & Hepatology
Julian R. F. Walters, Ramesh Arasaradnam, H. Jervoise N. Andreyev
FRONTLINE GASTROENTEROLOGY
(2020)
Review
Gastroenterology & Hepatology
Nunzia Labarile, Subrata Ghosh, Siew C. Ng, Julian Walters, Marietta Iacucci
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2020)