# Wondering what bile acid malabsorption is.



## hyacynth26 (Mar 3, 2002)

Can anyone help me out here? Thanks, may you all find it a diarrhea free day.


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## Kathleen M. (Nov 16, 1999)

Some background on bile (bile salts/bile acids)Your stomach can tell how fatty the meal you ate is.It tells the gall bladder how much bile to release. Your liver makes more bile in response to how much fat you eatBile is used to digest fat.If you do not have a gall bladder however much bile you produce is what you release so that makes part of the system that much less regulatable.Bile helps you digest the fat and at the end of the small intestine it is re-absobed and sent back to the liver to be recycled.Your small intestine can tolerate the presense of bile, but the colon is irritated by it when too much is present.Some people have had portions of their small intestine removed/damaged and cannot re-absorb the bile (which is what I think they typically mean by bile acid malabsorption).However it may be that some people are dis-regulated enough that they end up producing more than they recycle (after all there is only a finite amount you can recycle and if you release more than you need--and in IBS other signals seem to be messed up--you could be releasing more than is needed for digesting the fat and that could overwhelm the recycling part of the small intestine.In some people with IBS (diarrhea prone) and some people who have had their gall bladder removed and/or have damage to the small intestine taking Questran (a bile binder) can eliminate the diarrhea that comes from the colon being irritated (the only thing it can do is release water and mucus into the center and expel whatever is offending it out the back end).Questran is used to reduce cholesterol (and bran/fiber seems to work by a similar mechanism for this) by binding bile. When the liver has to make new bile it makes it from the cholesterol in your blood (so if you poop it out instead of recycling it you have to make more new than usual)HTHK.


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## stillgoing (Jan 7, 2002)

I was on Questran for about two years. I was diagnosed with Primary Bile Acid Malabsorption. The Questran helped, for a while, then I started to have D again. Dr. said to take more Questran. I took more, and more, and more. Finally it stopped working alltogether. The side effects(fatigue,muscle and joint pain,muscle wasting,hypoglycemia) were getting worse with each increase in dosage. I stopped taking Questran and all of the side effects went away( even though the DR. insisted Questran did not cause side effects). Bottomline Questran is good if malabsorption is your only problem. I think those of us with the most severe IBS/D have multiple problems. Malabsorption, stress ,psycological and physical. $64,000 question. How to treat all symptoms??? Good luck w/Questran......


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