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.
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:
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:
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
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.
Here are some websites that offer support for people with bile acid malabsorption (BAM):
is a charity that provides information and support to people with BAM. They have a website with information about the condition, as well as a forum where people can connect with others who are struggling with BAM.
is a charity that provides information and support to people with digestive conditions. They have a page on their website about BAM, which includes information about symptoms, diagnosis, and treatment.
IBD Relief is a website that provides information and support to people with inflammatory bowel disease (IBD). They have a page on their website about BAM, which is specifically relevant to people with IBD.
The Bile Acid Malabsorption and IBS Foundation
is a foundation that provides information and support to people with BAM and IBS. They have a website with information about the condition, as well as a forum where people can connect with others who are struggling with BAM and IBS.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is a part of the U.S. National Institutes of Health. They have a website with information about BAM, including information about symptoms, diagnosis, and treatment.