Yes, excess bile, specifically bile acids, can be harmful. When excess bile acids enter the colon, it can lead to Bile Acid Malabsorption (BAM), causing a range of unpleasant symptoms.
Understanding Bile Acid Malabsorption (BAM)
Bile acid malabsorption (BAM) occurs when the body doesn't properly reabsorb bile acids in the small intestine. This excess bile then enters the colon, leading to various digestive issues. According to research, BAM can cause:
- Watery stool
- Urgency to defecate
- Fecal incontinence
Although BAM has been linked to diarrhea for almost 50 years, it is still underrecognized and underdiagnosed as a cause of chronic diarrhea.
Signs and Symptoms of Excess Bile
Here's a breakdown of the signs and symptoms associated with excess bile in the colon, primarily due to BAM:
| Symptom | Description |
|---|---|
| Watery Stool | Loose, liquid bowel movements are a primary indicator. |
| Urgency | A sudden and compelling need to defecate. |
| Fecal Incontinence | Loss of bowel control, leading to accidental leakage. |
Causes of Bile Acid Malabsorption
Various factors can cause BAM, leading to an excess of bile acids in the colon:
- Ileal Resection: Surgical removal of the ileum (the end of the small intestine), which is the primary site for bile acid reabsorption.
- Ileal Disease: Conditions like Crohn's disease affecting the ileum.
- Idiopathic BAM: Cases where the cause is unknown.
Diagnosis and Treatment
It's essential to get a proper diagnosis to manage excess bile and its associated symptoms. Diagnostic tests may include:
- SeHCAT scan (Selenium-75-homocholic acid taurine)
- Fecal bile acid measurement
Treatment often involves:
- Bile acid sequestrants (medications that bind to bile acids in the intestine)
- Dietary modifications
