Suggest Treatment For Type 3 Biliary Acid Malabsorption In An IBS Patient

Brief Answer:
COllateral damage, easily managed

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. IBS is a functional bowel disease of Gastrointestinal tract. Always a multifactorial. Diet and lifestyle mismanagements, bowel habits and food preferences for dairy and fatty products all worsen it. Co morbid conditions and simple correlations from absorption enteropathies, infections, intolerances and variations in physiology of GIT in different people predispose it.

Now the issue of Type 3 biliary acid malabsorption is not a separate entity. its rather a collateral damage done due to IBS. Bile acids absorb in terminal ileum of small intestine. Functional issues like IBS and any other gastrointestinal diseases or gut procedures like cholecystectomy, vagotomy, small intestinal bacterial overgrowth, radiation enteropathy, celiac disease, chronic pancreatitis, etc may result in this bile absorption troubles. And it in turn causes worsening of IBS symptoms as more bile is produced, less in reabsorbed, and a continuous vicious circle and thus irritating bowel mucosa for further IBS symptoms.

The good thing is it is easily manageable. All you need is bile acid sequestrants like cholestyramine, colesevelam etc and modify diet, reduce fatty meal and use fibrates like niacin and take fibrous food.

Rest as far as IBS is concerned. I am sure you know the drill.

Dietary measures may include the following:

Fiber supplementation may improve symptoms of constipation and diarrhea
Polycarbophil compounds (eg, Citrucel, FiberCon) may produce less flatulence than psyllium compounds (eg, Metamucil)
Judicious water intake is recommended in patients who predominantly experience constipation
Caffeine avoidance may limit anxiety and symptom exacerbation
Legume avoidance may decrease abdominal bloating
Lactose and/or fructose should be limited or avoided in patients with these contributing disorders
Although the evidence is mixed regarding long-term improvement in GI symptoms with successful treatment of psychiatric comorbidities, the XXXXXXX College of Gastroenterology has concluded the following:

Psychological interventions, cognitive-behavioral therapy, dynamic psychotherapy, and hypnotherapy are more effective than placebo
Relaxation therapy is no more effective than usual care
Pharmacologic agents used for management of symptoms in IBS include the following:

Anticholinergics (eg, dicyclomine, hyoscyamine)
Antidiarrheals (eg, diphenoxylate, loperamide)
Tricyclic antidepressants (eg, imipramine, amitriptyline)
Prokinetics
Bulk-forming laxatives
Serotonin receptor antagonists (eg, alosetron)
Chloride channel activators (eg, lubiprostone)
Guanylate cyclase C (GC-C) agonists (eg, linaclotide)
Antispasmodics (eg, peppermint oil, pinaverium, trimebutine, cimetropium/dicyclomine)

I hope it helps. take good care of yourself and dont forget to close the discussion please.

May the odds be ever in your favour.

Regards
Khan

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Brief Answer:
:)

Detailed Answer:
Thank you for getitng back!

Good luck with that.. It will be prescribed easily. You should feel a difference soon.

take care.
Khan

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