X Fan1, J H Sellin. 1. Division of Gastroenterology, University of Texas Medical Branch, Galveston, TX, USA.
Abstract
BACKGROUND: Chronic watery diarrhoea is one of the most common symptoms prompting GI evaluation. Recently, new diagnostic considerations have emerged as possible factors in chronic diarrhoea. AIM: To review available data regarding diagnosis and treatment of chronic diarrhoea with an emphasis on bacterial overgrowth and bile acid malabsorption. METHODS: A systematic search of the English language literature of chronic diarrhoea was performed focused on three possible aetiologies of diarrhoea: small intestinal bacterial overgrowth (SIBO), idiopathic bile salt malabsorption (IBAM), gluten responsive enteropathy. RESULTS: Recent studies suggest that SIBO and bile acid malabsorption may have been underestimated as possible causes of chronic watery diarrhoea. Gluten intolerance with negative coeliac serology is a contentious possible cause of watery diarrhoea, but requires further research before acceptance as an entity. CONCLUSION: In patients with otherwise unexplained chronic watery diarrhoea, small intestinal bacterial overgrowth and bile salt malabsorption should be considered and investigated.
BACKGROUND: Chronic watery diarrhoea is one of the most common symptoms prompting GI evaluation. Recently, new diagnostic considerations have emerged as possible factors in chronic diarrhoea. AIM: To review available data regarding diagnosis and treatment of chronic diarrhoea with an emphasis on bacterial overgrowth and bile acid malabsorption. METHODS: A systematic search of the English language literature of chronic diarrhoea was performed focused on three possible aetiologies of diarrhoea: small intestinal bacterial overgrowth (SIBO), idiopathic bile salt malabsorption (IBAM), gluten responsive enteropathy. RESULTS: Recent studies suggest that SIBO and bile acid malabsorption may have been underestimated as possible causes of chronic watery diarrhoea. Gluten intolerance with negative coeliac serology is a contentious possible cause of watery diarrhoea, but requires further research before acceptance as an entity. CONCLUSION: In patients with otherwise unexplained chronic watery diarrhoea, small intestinal bacterial overgrowth and bile salt malabsorption should be considered and investigated.
Authors: Jonas F Ludvigsson; Daniel A Leffler; Julio C Bai; Federico Biagi; Alessio Fasano; Peter H R Green; Marios Hadjivassiliou; Katri Kaukinen; Ciaran P Kelly; Jonathan N Leonard; Knut Erik Aslaksen Lundin; Joseph A Murray; David S Sanders; Marjorie M Walker; Fabiana Zingone; Carolina Ciacci Journal: Gut Date: 2012-02-16 Impact factor: 23.059
Authors: Jan Bures; Jiri Cyrany; Darina Kohoutova; Miroslav Förstl; Stanislav Rejchrt; Jaroslav Kvetina; Viktor Vorisek; Marcela Kopacova Journal: World J Gastroenterol Date: 2010-06-28 Impact factor: 5.742