Bile Acid Disease: The Emerging Epidemic #MMPMID28169840
Oduyebo I; Camilleri M
Curr Opin Gastroenterol 2017[May]; 33 (3): 189-95 PMID28169840show ga
Purpose of Review: Our objective was to review advances in bile acids (BA) in health and disease published in the last two years. BA diarrhea (BAD) is recognized as a common cause of chronic diarrhea, and its recognition has been facilitated by development of new screening tests. Recent Findings: Primary BAD can account for 30% of cases of chronic diarrhea. The mechanisms leading to BAD include inadequate feedback regulation by fibroblast growth factor 19 (FGF-19) from ileal enterocytes, abnormalities in synthesis or degradation of proteins involved in FGF-19 regulation in hepatocytes, and variations in function of the bile acid receptor, TGR5 (GPBAR1).75SeHCAT is the most widely used test for diagnosis of BAD. There has been significant validation of fasting serum FGF-19 and 7 ?-hydroxy-cholesten-3-one (C4), a surrogate measure of BA synthesis.BA sequestrants are the primary treatments for BAD; the FXR-FGF-19 pathway provides alternative therapeutic targets for BAD.BA-stimulated intestinal mechanisms contribute to the beneficial effects of bariatric surgery on obesity, glycemic control, and the treatment of recurrent C. difficile infection. Summary: Renewed interest in the role of BAs is leading to novel management of diverse diseases besides BAD.
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Curr+Opin+Gastroenterol 2017 ; 33 (3): 189-95
