Bile acid disease

Oduyebo, Ibironke; Camilleri, Michael

doi:10.1097/mog.0000000000000344

Cited by 31 publications

(20 citation statements)

References 31 publications

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“…A chronic, watery diarrhea is a common occurrence in patients with bile acid malabsorption (BAM), a condition known to be characterized by significant clinical heterogeneity [1]. BAM is known to worsen the patients’ quality of life and be a challenge for many healthcare services because of direct and indirect costs [2, 3]. Recently, several research groups have focused their interest to altered bile acid (BA) excretion and reabsorption as a prominent cause of chronic diarrhea [2].…”

Section: Introductionmentioning

confidence: 99%

“…BAM is known to worsen the patients’ quality of life and be a challenge for many healthcare services because of direct and indirect costs [2, 3]. Recently, several research groups have focused their interest to altered bile acid (BA) excretion and reabsorption as a prominent cause of chronic diarrhea [2]. Nonetheless, the mechanisms leading to excessive accumulation of BAs are still only partly defined.…”

Section: Introductionmentioning

confidence: 99%

“…In the clinical setting, current main methods to diagnose BAM include the scintigraphic method 75 Selenium-homotaurocholic acid test ( 75 SeHCAT), the serum levels of 7-α-hydroxy-4-cholesten-3-one (C4) and FGF19, whereas bile acid (BA) excretion can be determined in stools over 48 h [2, 3]. Studies using SeHCAT have identified four subtypes of BAM generally recognized as: a) ileal disease preventing BA reabsorption, e.g.…”

Section: Introductionmentioning

confidence: 99%

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Methods for diagnosing bile acid malabsorption: a systematic review

et al. 2019

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BackgroundBile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests. We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking.MethodsA PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.ResultsOverall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n = 8 studies used 75Selenium-homotaurocholic-acid-test (75SeHCAT) with a < 10% retention threshold; n = 8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n = 3 studies involved total fecal bile acid (BA) excretion over 48 h; n = 4 studies assessed fibroblast growth factor 19 (FGF19). 75SeHCAT showed an average sensitivity and specificity of 87.32 and 93.2%, respectively, followed by serum C4 (85.2 and 71.1%) and total fecal BA (66.6 and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8 and 72.3%). All the extracted data were associated with substantial heterogeneity.ConclusionsOur systematic review indicates that 75SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Methods for diagnosing bile acid malabsorption: a systematic review

et al. 2019

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show abstract

“…In the clinical setting, current main methods to diagnose BAM include the scintigraphic method 75 Sehomotaurocholic acid test ( 75 SeHCAT), the serum levels of 7-α-hydroxy-4-cholesten-3-one (C4) and FGF19, whereas bile acid (BA) excretion can be determined in stools over 48 hours [2] [3]. Studies using SeHCAT have identified four subtypes of BAM generally recognized as: a) ileal disease preventing BA reabsorption, e.g.…”

Section: Introductionmentioning

confidence: 99%

Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

Lyutakov

Ursini

Penchev

et al. 2019

Preprint

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BackgroundBile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.ObjectiveTo perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with bile acid malabsorption.DesignA PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.ResultsOverall, more than one tests was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.ConclusionsOur systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

show abstract

Section: Introductionmentioning

confidence: 99%

Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

Lyutakov

Ursini

Penchev

et al. 2019

Preprint

View full text Add to dashboard Cite

Background Bile acid malabsorption (BAM) and bile acid-related diarrhea represent an under-recognized cause of chronic diarrhea mainly because of limited guidance on appropriate diagnostic and laboratory tests.Objective We aimed to perform a systematic review of the literature in order to identify and compare the diagnostic accuracy of different diagnostic methods for patients with BAM, despite a proven gold standard test is still lacking.Design A PubMed literature review and a manual search were carried out. Relevant full papers, evaluating the diagnostic accuracy of different methods for BAM, were assessed. Available data were analyzed to estimate the sensitivity and specificity of each published test.Results Overall, more than one test was considered in published papers on BAM. The search strategy retrieved 574 articles; of these, only 16 were full papers (with a total of 2.332 patients) included in the final review. Specifically, n=8 studies used 75 Selenium-homotaurocholic-acid-test ( 75 SeHCAT) with a <10% retention threshold; n=8 studies evaluated fasting serum 7-α-hydroxy-4-cholesten-3-one (C4); n=3 studies involved total fecal bile acid (BA) excretion over 48h; n=4 studies assessed fibroblast growth factor 19 (FGF19). 75 SeHCAT showed an average sensitivity and specificity of 87.32% and 93.2%, respectively, followed by serum C4 (85.2% and 71.1%) and total fecal BA (66.6% and 79.3%). Fasting serum FGF19 had the lowest sensitivity and specificity (63.8% and 72.3%). All the extracted data were associated with substantial heterogeneity.Conclusions Our systematic review indicates that 75 SeHCAT has the highest diagnostic accuracy for BAM, followed by serum C4 assay. The diagnostic yield of fecal BA and FGF19 assays is still under investigation. Our review reinforces the need for novel biomarkers aimed to an objective detection of BAM and therefore improving the management of this condition.

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Bile acid disease

Cited by 31 publications

References 31 publications

Methods for diagnosing bile acid malabsorption: a systematic review

Methods for diagnosing bile acid malabsorption: a systematic review

Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

Methods for Diagnosing Bile Acid Malabsorption: A Systematic Review

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