040 68334455
WhatsApp
Patient Portal
Home Care
What is Bile Acid Malabsorption?
Written by Medicover Team and Medically Reviewed by Dr Telli Venkata Pradeep Kumar , Gastroenterologists Medical
Bile acid malabsorption (BAM) happens when your small intestine can't absorb bile acids properly. These bile acids then move into your colon and cause frequent, watery diarrhoea. BAM affects your digestion, making it harder for your body to absorb fats and nutrients. Early diagnosis and treatment can help improve your digestion and overall health.
Common causes include
- Crohn's disease,
- Gallbladder removal, or other
- Small intestine problems.
BAM affects fat digestion and nutrient absorption, so early treatment helps avoid serious issues.
What are the Bile Acid Malabsorption Symptoms?
Bile acid malabsorption (BAM) can cause different digestive problems that affect your daily life. Recognizing these early can help you get the right treatment and avoid more serious issues.
- Watery diarrhoea (most common, often sudden and hard to control)
- Frequent bowel movements, sometimes several times a day
- Bloating and gas, making your belly feel swollen or tight
- Cramping or stomach pain, usually before or after using the bathroom
- Urgency to go, sometimes leading to accidents
- Fatty or oily stools (may float or look pale)
Bile Acid Malabsorption Warning Signs
- Unexplained weight loss, due to poor nutrient absorption
- Dehydration (feeling very thirsty, dizzy, or weak)
- Severe fatigue, feeling worn out or lacking energy
- Nutrient deficiencies, leading to weakness or frequent illness
What are the Causes of Bile Acid Malabsorption?
Doctors do recognise different types of bile acid malabsorption (BAM), based on what causes it. Knowing the type can help guide the best treatment and improve your digestive health.
BAM caused by ileal disease or surgery
This type happens when the last part of your small intestine (the ileum) is damaged or removed. It is common in people with Crohn's disease or those who have had ileal surgery. The ileum normally absorbs bile acids, so if it's not working well, bile acids leak into the colon.
Primary or idiopathic BAM
This type means there's no clear underlying disease or surgery causing it. The small intestine appears normal, but it still doesn't absorb bile acids properly. The exact reason is not fully understood. This type is sometimes called primary bile acid diarrhoea.
BAM secondary to other gastrointestinal conditions
This type is linked to other digestive problems such as:
- Gallbladder removal (cholecystectomy)
- Small intestinal bacterial overgrowth (SIBO)
- Celiac disease
- Chronic pancreatitis
Below is a simple breakdown of common and more severe symptoms so you know when to seek medical help.
Get a second opinion from trusted experts and makeconfident, informed decisions.
Get Second OpinionHow is Bile Acid Malabsorption Diagnosed?
Bile acid malabsorption (BAM) can be tricky to diagnose because its main symptoms, like chronic diarrhea and bloating, often look like other gut problems. Accurate tests help confirm BAM so you can get proper treatment.
Key Diagnostic Tests
SeHCAT Test (Gold Standard)
- The SeHCAT test is the most accurate test for BAM.
- You swallow a small capsule containing a safe, low-dose radioactive tracer that acts like bile acid.
- Doctors use a special scanner to track how well your body holds onto these bile acids over a week.
- Low retention means bile acids aren't being absorbed properly, confirming BAM.
Serum C4 Blood Test
- This blood test measures a substance called C4, which shows how much bile acid your liver is making.
- High C4 levels suggest your body is losing bile acids in the gut and making more to replace them.
- It's a good alternative when SeHCAT isn't available.
Fecal Bile Acid Test
- This test checks the amount of bile acid in your stool.
- You follow a special diet, then collect stool samples over 48 hours.
- High bile acid levels mean your intestines aren't absorbing them properly, causing diarrhoea.
What are the Treatment Options for Bile Acid Malabsorption?
Bile acid malabsorption (BAM) can cause constant diarrhoea and stomach discomfort. Treatment helps control bile acid diarrhoea, improve nutrient absorption, and protect digestive health.
Medications (Bile Acid Sequestrants)
- Medicines like cholestyramine, colestipol, and colesevelam bind extra bile acids in your gut.
- They reduce watery diarrhoea and make stools firmer.
- Many people start feeling better in a few days to a few weeks.
Low-Fat Diet
- Eating less fat lowers bile acid production, helping with the treatment of chronic diarrhoea.
- Adding soluble fibre (oats, apples, bananas) helps bind bile acids and improve digestion.
- Diet changes usually help within weeks.
Treating the Cause
- If BAM is linked to Crohn's disease, celiac disease, or gallbladder removal, treating these conditions is key.
- Fixing the root problem improves bile acid absorption and overall digestive health.
Recovery Timeline
- Symptoms often improve in 1-2 weeks with medication or diet changes.
- Full recovery depends on the cause but usually takes a few weeks.
When to See a Bile Acid Malabsorption Doctor?
It's important to see a doctor if you have ongoing digestive problems. Bile acid malabsorption (BAM) can cause chronic diarrhoea and lead to dehydration, weight loss, and poor nutrient absorption if left untreated.
Diarrhoea lasts more than 1-2 weeks, especially if it's watery and frequent.
Unexplained weight loss or difficulty maintaining weight.
Severe bloating, cramping, or urgency, making daily life difficult.
Signs of dehydration include extreme thirst, dry mouth, dizziness, or weakness.
Who is at higher risk?
- People with Crohn's disease, celiac disease, or a history of gallbladder removal.
- Anyone with long-term gut problems that do not improve with fundamental dietary changes.
- Older adults or people with other chronic conditions affecting digestive health.
Why is seeing a doctor important?
Doctors don't just treat the symptoms, they look for the root cause. A gastroenterology specialist can run tests (like the SeHCAT test or blood tests) to confirm BAM and start proper treatment, such as bile acid sequestrants or diet changes.
Early care helps prevent complications like vitamin deficiencies, severe dehydration, and ongoing gut damage.
A digestive health specialist or gastroenterologist can help find the cause and start the right treatment to improve your quality of life.
Your health is everything - prioritize your well-being today.
Consult Bile Acid Malabsorption Doctors Today
What Precautions Can Help Prevent Bile Acid Malabsorption?
Bile acid malabsorption (BAM) can't always be fully prevented, especially when it's caused by conditions like Crohn's disease or gallbladder removal. But some healthy habits can protect your digestive health and reduce risks.
Bile Acid Malabsorption Prevention Tips
- Eat a balanced, low-fat diet to reduce bile acid overload and support better digestive health.
- Add more soluble fibre (oats, apples, bananas) to help absorb excess bile acids.
- Stay hydrated to support healthy digestion and avoid dehydration from diarrhoea.
- Get regular screenings if you have Crohn's disease, celiac disease, or have had a gallbladder removal. Early checks help catch changes before they become severe.
- Follow up with your gastroenterologist if you have long-term gut issues or unexplained diarrhoea.
Possible Complications if Untreated
- Chronic diarrhoea leading to dehydration and weakness.
- Nutrient and vitamin deficiencies from poor absorption.
- Unintentional weight loss and muscle weakness.
- Increased risk of gallstones or other bile-related digestive problems.
- Overall decline in quality of life and energy levels.
Our Experience in Treating Bile Acid Malabsorption
At Medicover, we care deeply about each patient's digestive health journey. With advanced diagnostics, skilled gastroenterology specialists, and personalized treatment plans, we aim to help you regain control of your gut health and enjoy life without constant worry.
Your comfort and well-being are at the heart of everything we do.
