Year: 2015
Type: editorial
Abstract: The comments provided by Julian Walters and Richard Appleby1 regarding the recent Mayo Clinic study of the effects of colesevelam on faecal bile acids in IBS with diarrhoea are very much appreciated.2 In addition to their excellent comments, I wish to clarify for the readers that the increased bile acids in stool were sequestered and only released during the methanol extraction step; therefore, the increase in bile acids reaching the colon were biologically inactive, thereby reducing their diarrhoeagenic potential, as manifested by the improvement in stool consistency. The observed increase in serum C4 level, a surrogate for the rate of hepatic synthesis of bile acids, may compensate for the intraluminal sequestration by colesevelam of bile acids in the small intestine, and avoid aggravating the mild steatorrhoea observed in these patients with IBS-diarrhoea.3 The author's declarations of personal and financial interests are unchanged from those in the original article.2
DOI: 10.1111/apt.13111
Author: M. Camilleri
Institution: Mayo Clinic
Language: English
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2013421576