As you may know, bile is vital for proper digestion. It contains salts, proteins, acids, and many other products, and it is produced on a daily level by your liver. From the liver, it is later transported to the gallbladder where it is stored. When there is food in the gut that needs to be digested, bile is released and used in the process. When the digestion process is over, the bile acids are reabsorbed in the bloodstream and used again next time. Sometimes, the bile acids are not absorbed properly, and that leads to the condition that we are talking about today – bile acid diarrhea.
What Causes Bile Acid Diarrhea?
Bile acid diarrhea also referred to as bile salt diarrhea and bile acid malabsorption is a medical condition that occurs whenever your intestines are not capable of proper bile acid absorption. The result is extra bile acids being present in the intestines, causing watery diarrhea to occur.
There are two types of bile acid diarrhea
- A primary which is caused by unknown causes and
- A secondary that can be caused by a long list of underlying conditions.
One-third of the patients with irritable bowel syndrome are struggling with bile acid diarrhea, as well. Other causes can be celiac disease, Crohn’s disease, pancreatic diseases, etc.
Can Bile Acid Diarrhea Cause Fatigue?
Yes, bile acid diarrhea is commonly reported to cause fatigue, low energy levels, low stamina, lack of concentration, low mood, and feeling unwell. Although there is no exact explanation for these symptoms, it might be the dehydration that is causing these symptoms. When you are experiencing diarrhea, your body is often dehydrating, which is why it is so important to replace the lost fluids and electrolytes.
What Are The Symptoms Of Bile Acid Diarrhea?
Apart from the symptoms that we mentioned a few moments before, the most characteristic symptom of bile acid malabsorption is watery diarrhea. Salt and water from the bile acid are preventing a proper stool formation, which results in frequent, watery diarrhea. The bile acid diarrhea color is characteristically yellow and can even appear to be greasy. Diarrhea can occur every day, during the day or night, or only occasionally. Most of the symptoms are related to the digestive system and include bloating, abdominal cramps, flatulence, nausea, etc.
How Do You Test For Bile Salt Diarrhea?
Unfortunately, bile acid diarrhea is hard to diagnose. On average, it takes around five years for a clear diagnosis to be made. One of the most commonly used tests to detect bile acid diarrhea is called the SeHCAT test, which uses low-dose radiation.
This test, however, is currently unavailable in the United States. In the United States, the patients who are suspected of struggling with bile acid diarrhea, are given medications used to treat this condition. If the patient’s condition improves with the help of the medication, that is used as an indication that it truly is a case of bile acid diarrhea that the patient is struggling with. However, this is what causes the diagnosis to take up to several years since not all patients have been reported to tolerate the used medications, nor do these medications cause the same effects in every patient with bile acid diarrhea.
Bile Acid Diarrhea Natural Treatment
In case that it is an underlying condition that has been causing the symptoms of bile acid diarrhea, its symptoms will be eliminated as soon as the proper treatment method has been used. If it is a case of idiopathic bile acid diarrhea, then patients are advised to pursue a combination of medications and dietary changes.
Currently, the use of bile acid binder, a medication that binds with bile acids in the digestive tract in order to reduce the present bile acid diarrhea and its symptoms, has been proven to be quite effective in the treatment of this condition.
As for the dietary changes – a low-fat diet is recommended. This can help reduce the amount of bile that is produced in the body since bile is essential for the digestion of fats in the body. Avoiding caffeine can also help since it is known to act as a stimulant for your digestive system. Balancing out the blood sugar levels will reflect positively on your condition, as well.
Bile acid malabsorption causes difficult symptoms that have a great negative influence on the patient’s life and overall health. From watery diarrhea, fatigue, nausea, low stamina, difficulty concentrating, bile acid diarrhea can cause many symptoms that are hard to diagnose. The diagnosis can take up to several years, but the good news is that with proper treatment, many patients are able to continue living a normal life.
Doctor, author and fitness enthusiast, Ahmed Zayed, MD, is a surgery resident with a passion for helping people live a happy healthy life. He is the author of numerous health-related books and contributor to several medicine, health and wellbeing.