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Digestive Diseases and Sciences

, Volume 46, Issue 10, pp 2231–2238 | Cite as

Bile Acid Malabsorption in Microscopic Colitis and in Previously Unexplained Functional Chronic Diarrhea

  • Fernando Fernández-Bañares
  • Maria Esteve
  • Antonio Salas
  • Montserrat Forné
  • Jorge C. Espinós
  • Josep Martín-Comín
  • Josep Maria Viver
Article

Abstract

Bile acid malabsorption (BAM) has been described in patients with collagenous colitis. There are no similar studies in lymphocytic colitis. The possibility that BAM might not necessarily be part of the microscopic colitis process and that both entities could simply be concomitant has not been evaluated. Our aim was to assess the frequency and severity of BAM in patients with microscopic colitis as well as in patients with previously unexplained functional chronic diarrhea. Likewise, we wanted to investigate the effect of cholestyramine on the induction and maintenance of remission of these conditions. A [75Se]HCAT abdominal retention test was performed in 26 patients with collagenous colitis, 25 with lymphocytic colitis, and 32 with previously unexplained functional chronic diarrhea. Patients with microscopic colitis who had BAM as well as a subgroup of eight collagenous colitis patients without BAM received treatment with cholestyramine. All patients with previously unexplained chronic diarrhea who had BAM were treated with cholestyramine. Twenty-two (43.1%) patients with microscopic colitis and 24 (75%) patients with previously unexplained functional chronic diarrhea presented with BAM. The frequency of BAM was higher in lymphocytic colitis than in collagenous colitis (60% vs 27%; P = 0.025). Cholestyramine induced clinical remission in 19 of 22 patients with microscopic colitis and BAM, none of eight patients with collagenous colitis without BAM, and all patients with previously unexplained chronic diarrhea and BAM. In conclusion, BAM seems to be common in patients with microscopic colitis—mainly in lymphocytic colitis—and in those with previously unexplained functional chronic diarrhea, suggesting that idiopathic BAM and microscopic colitis are often concomitant conditions. In this setting, cholestyramine seems to be highly effective in stopping diarrhea.

collagenous colitis lymphocytic colitis functional chronic diarrhea bile acid malabsorption cholestyramine 

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Copyright information

© Plenum Publishing Corporation 2001

Authors and Affiliations

  • Fernando Fernández-Bañares
    • 1
  • Maria Esteve
    • 1
  • Antonio Salas
    • 2
  • Montserrat Forné
    • 1
  • Jorge C. Espinós
    • 1
  • Josep Martín-Comín
    • 3
  • Josep Maria Viver
    • 1
  1. 1.Department of GastroenterologyHospital Universitari Mútua de Terrassa, TerrassaBarcelonaSpain
  2. 2.Department of PathologyHospital Universitari Mútua de Terrassa, TerrassaBarcelonaSpain
  3. 3.Department of Nuclear MedicineHospital de Bellvitge, L'Hospitalet de LlobregatBarcelonaSpain

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