Bile acid malabsorption in oncology patients

Czech version

Authors: D. Kohoutová ^1,2; D. Zogala ³; J. Doležal ⁴; O. Lang ^5,6; J. Bureš ^1,7,8
Authors‘ workplace: Centrum biomedicínského výzkumu, FN Hradec Králové ¹; The Royal Marsden NHS Foundation Trust, London ²; Ústav nukleární medicíny 1. LF UK a VFN v Praze ³; Oddělení nukleární medicíny, FN Hradec Králové ⁴; Klinika nukleární medicíny 3. LF UK a FN Královské Vinohrady, Praha ⁵; Oddělení nukleární medicíny, Prague Medical Care Department, Praha ⁶; Ústav gastrointestinální onkologie ÚVN – Vojenská fakultní nemocnice Praha ⁷; Interní klinika 1. LF UK a ÚVN – Vojenská fakultní nemocnice Praha ⁸
Published in: Gastroent Hepatol 2022; 76(5): 399-408
Category: Gastrointestinal Oncology: Review Article
doi: https://doi.org/10.48095/ccgh2022399

Overview

Bile acid malabsorption (BAM) is caused by dysregulation of enterohepatic circulation of bile acids and their synthesis in the liver. Estimated prevalence is about 1% of adult population. BAM has been substantially underdiagnosed. This condition can be present in one third of patients with diarrhoea-predominant irritable bowel syndrome and in 50–100% of Crohn‘s disease with ileitis or previously resected terminal ileum. Up to one half of oncology patients with pelvic radiotherapy suffer from BAM. SeHCAT test (⁷⁵Selenium HomoCholic Acid Taurine test) is the gold diagnostic standard and the test has just become available in the Czech Republic. Low-fat diet is the most important dietary modification. Bile acids sequestrants (cholestyramine in the Czech Republic) are the crucial part of pharmacotherapy.

Keywords:

bile acid malabsorption – SeHCAT test – cholestyramine

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