B.A.M

What is bile acid malabsorption?
Bile acids are produced by the liver and stored in the gallbladder. They are released into the small intestine to help digest fats. Bile acids are then reabsorbed back into the bloodstream through the ileum, the last part of the small intestine.

Bile acid malabsorption (BAM) occurs when too much bile acid is lost in the stool. This can happen for a number of reasons, including:

Ileal resection or Crohn's disease:
Which can damage the ileum and prevent bile acids from being reabsorbed.

Rapid small bowel transit:
Which can cause bile acids to pass through the small intestine too quickly to be reabsorbed.

Bacterial overgrowth in the small intestine: (SIBO)
Which can produce enzymes that break down bile acids.

Medications:
Such as cholestyramine and colestipol, which can bind to bile acids and prevent them from being absorbed.

Symptoms of bile acid malabsorption

The symptoms of BAM can vary from person to person, but they often include:

→Diarrhea
→Abdominal pain
→Bloating
→Gas
→Weight loss
→Fatigue
→Constipation

How does BAM affect people with IBS?

People with IBS are more likely to develop BAM than people without IBS. This is because IBS can cause inflammation and damage to the small intestine, which can make it more difficult for bile acids to be reabsorbed.

BAM can worsen the symptoms of IBS, including diarrhea, abdominal pain, bloating, and gas. It can also make it more difficult to manage IBS.

Treatment for bile acid malabsorption

The treatment for BAM depends on the underlying cause. If BAM is caused by a medication, the medication may need to be stopped or changed. If BAM is caused by a medical condition, such as Crohn's disease or ileal resection, treatment for the underlying condition may help to improve bile acid absorption.

There are also a number of medications that can be used to treat BAM. These medications include:

→Cholestyramine
→Colestipol
→Colesevelam
→Rifaximin
These medications work by binding to bile acids in the small intestine and preventing them from being absorbed. This can help to reduce the symptoms of BAM.

Diet and lifestyle changes

There are also a number of diet and lifestyle changes that can help to manage BAM. These include:

•Eating a low-fat diet
•Avoiding foods that are high in fat, such as red meat, dairy products, and fried foods
•Eating small, frequent meals
•Drinking plenty of fluids
•Getting regular exercise
•Managing stress

These changes can help to reduce the amount of bile acids that are released into the small intestine and improve the symptoms of BAM.

If you are experiencing symptoms of BAM, it is important to see a doctor. BAM can be a difficult condition to diagnose, but it is important to get treatment to manage the symptoms and prevent complications.