Bile acid diarrhea (BAD) is a common, under-investigated cause of chronic diarrhea. We aimed to assess the current management of BAD among a group of Italian physicians. A survey was developed by a task force of experts and distributed via the Internet to Italian physicians members of the main Italian gastroenterological associations. Ninety-four physicians accepted to participate, of whom 44% were females. The majority of participants were gastroenterologists (63%) and the mean age was 50.5 years. No differences in the rate of BAD diagnosis among patients with chronic diarrhea were found according to medical specialization. Gastroenterologists reported a higher prevalence of BAD compared with other physicians/general practitioners (1% vs 0.3%). BAD suspicion is mostly raised in the presence of watery stools and > 3 bowel movements/day and the exclusion of organic/drug-related diseases. BAD diagnosis was assessed with 75SeHCAT (67.8% of gastroenterologists and 51.4% of other physicians), followed by a trial of cholestyramine (30.5% of gastroenterologists and 31.4% of other physicians). Therapies most prescribed for BAD were cholestyramine, a low-fat diet, and stool thickeners. BAD is a common condition generally suspected in the presence of chronic watery diarrhea. 75SeHCAT availability influences the awareness of this disease. Therapies currently are often not able to guarantee adequate symptom relief.

Management of bile acid diarrhea in Italy: a survey

Bellini M.;
2025-01-01

Abstract

Bile acid diarrhea (BAD) is a common, under-investigated cause of chronic diarrhea. We aimed to assess the current management of BAD among a group of Italian physicians. A survey was developed by a task force of experts and distributed via the Internet to Italian physicians members of the main Italian gastroenterological associations. Ninety-four physicians accepted to participate, of whom 44% were females. The majority of participants were gastroenterologists (63%) and the mean age was 50.5 years. No differences in the rate of BAD diagnosis among patients with chronic diarrhea were found according to medical specialization. Gastroenterologists reported a higher prevalence of BAD compared with other physicians/general practitioners (1% vs 0.3%). BAD suspicion is mostly raised in the presence of watery stools and > 3 bowel movements/day and the exclusion of organic/drug-related diseases. BAD diagnosis was assessed with 75SeHCAT (67.8% of gastroenterologists and 51.4% of other physicians), followed by a trial of cholestyramine (30.5% of gastroenterologists and 31.4% of other physicians). Therapies most prescribed for BAD were cholestyramine, a low-fat diet, and stool thickeners. BAD is a common condition generally suspected in the presence of chronic watery diarrhea. 75SeHCAT availability influences the awareness of this disease. Therapies currently are often not able to guarantee adequate symptom relief.
2025
Marasco, G.; Barbara, G.; Bellini, M.; Portincasa, P.; Stanghellini, V.; Annibale, B.; Benedetti, A.; Cammarota, G.; Fries, W.; Usai Satta, P.; Corazz...espandi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/1361349
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