Bile acid diarrhea impacts bowel symptoms, quality of life in IBS-D
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Bile acid diarrhea had a greater impact on bowel symptoms and quality of life in patients with irritable bowel syndrome with diarrhea compared to those without it had, according to study results.
“We conclude that patients with [bile acid diarrhea (BAD)] had higher BMI, took more antidiarrheal agents and had more severe and frequent diarrhea, as well as urgency,” Joelle BouSaba, MD, of the department of quantitative health sciences at the Mayo Clinic in Rochester, Minnesota and colleagues wrote in Clinical Gastroenterology and Hepatology. “These symptoms interfere with daily activities, and the impact is confirmed on a rigorous regression model. The study adds to the body of evidence, including impact on healthcare utilization, that searching for evidence of BAD is relevant in patients with IBS-D especially in those with more severe and frequent diarrhea associated with urgency.”
BouSaba and colleagues gave 219 patients with IBS-D questionnaires to complete including bowel disease questionnaire, Hospital Anxiety and Depression (HAD) Inventory, general QOL (SCL-90) and IBS-specific quality of life (IBS-QOL). For BAD, investigators used fasting serum 7a-hydroxy-4-cholesten-3-one less than 52.5 ng/mL as a biomarker. Predictors of BAD in IBS-D were identified with a multiple variable logistic model.
Of the 219 patients, 44 had BAD. Investigators noted patients with bile acid diarrhea compared with those without were significantly older and had a higher BMI. An impact on IBS-QOL and more severe bowel dysfunction were observed in patients with BAD compared with those without it.
According to BouSaba and colleagues, patients with BAD were more likely to receive antidiarrheals, bile acid binders and antacid secret agents compared with other IBS-D groups. Predictors of BAD in IBS-D included severity of diarrhea and need of toilet proximity (P < .01). Those with bile acid diarrhea compared to those without it had a depression score greater than 8 on the HAD Inventory.
“Screening for BAD in IBS-D is especially relevant with more severe and frequent diarrhea along with urgency,” BouSaba and colleagues wrote.
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