{"title":"Diagnostic and therapeutic yield of 72h stool collection combined with bile acid quantification: a retrospective analysis.","authors":"F Gelders, J Tack, T Vanuytsel","doi":"10.51821/88.3.13758","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and study aims: </strong>Chronic idiopathic diarrhea represents a diagnostic and therapeutic challenge to gastroenterologists. We aimed to explore the diagnostic and therapeutic yield of 72h stool collection combined with bile acid quantification, in chronic diarrhea patients, to differentiate bile acid malabsorption from other causes of diarrhea and thus enabling tailored treatment.</p><p><strong>Patients and methods: </strong>We performed a retrospective study on 252 stool collections combined with bile acid quantification. Descriptive statistics, Pearson correlation analysis and ANOVA with post hoc between-group t-tests were used.</p><p><strong>Results: </strong>Idiopathic bile acid diarrhea was present in up to one third of patients with diarrhea-predominant IBS and functional diarrhea. Steatorrhea was highly prevalent both in patients with a clinical suspicion of fat malabsorption (57%) as well as patients with non-specific diarrhea (23%). We show a significant difference in fecal bile acid and fat content in patients with vs. without predisposing risk factors for bile acid or fat malabsorption (e.g. cholecystectomy). The prevalence of steatorrhea was also significantly higher in patients with previous enteric resection or bariatric surgery. Bile acid diarrhea was significantly more frequent in patients with previous colonic resection, probably due to combined resection of a distal ileal segment during right hemicolectomy. We could not show higher rates of bile acid diarrhea post-cholecystectomy compared to the other groups.</p><p><strong>Conclusion: </strong>Bile acid diarrhea and steatorrhea are prevalent findings in patients with chronic diarrhea. Using this 72h stool analysis with bile acid quantification can help clinicians in the complex management of chronic diarrhea.</p>","PeriodicalId":7322,"journal":{"name":"Acta gastro-enterologica Belgica","volume":"88 3","pages":"245-252"},"PeriodicalIF":1.2000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta gastro-enterologica Belgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.51821/88.3.13758","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and study aims: Chronic idiopathic diarrhea represents a diagnostic and therapeutic challenge to gastroenterologists. We aimed to explore the diagnostic and therapeutic yield of 72h stool collection combined with bile acid quantification, in chronic diarrhea patients, to differentiate bile acid malabsorption from other causes of diarrhea and thus enabling tailored treatment.
Patients and methods: We performed a retrospective study on 252 stool collections combined with bile acid quantification. Descriptive statistics, Pearson correlation analysis and ANOVA with post hoc between-group t-tests were used.
Results: Idiopathic bile acid diarrhea was present in up to one third of patients with diarrhea-predominant IBS and functional diarrhea. Steatorrhea was highly prevalent both in patients with a clinical suspicion of fat malabsorption (57%) as well as patients with non-specific diarrhea (23%). We show a significant difference in fecal bile acid and fat content in patients with vs. without predisposing risk factors for bile acid or fat malabsorption (e.g. cholecystectomy). The prevalence of steatorrhea was also significantly higher in patients with previous enteric resection or bariatric surgery. Bile acid diarrhea was significantly more frequent in patients with previous colonic resection, probably due to combined resection of a distal ileal segment during right hemicolectomy. We could not show higher rates of bile acid diarrhea post-cholecystectomy compared to the other groups.
Conclusion: Bile acid diarrhea and steatorrhea are prevalent findings in patients with chronic diarrhea. Using this 72h stool analysis with bile acid quantification can help clinicians in the complex management of chronic diarrhea.
期刊介绍：
The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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