Management of bile acid diarrhea in Italy: a survey

Bile acid diarrhea (BAD) is a common, under-investigated cause of chronic diarrhea. We aimed to assess the current management of BAD among a group of Italian physicians. A survey was developed by a task force of experts and distributed via the Internet to Italian physicians members of the main Italian gastroenterological associations. Ninety-four physicians accepted to participate, of whom 44% were females. The majority of participants were gastroenterologists (63%) and the mean age was 50.5 years. No differences in the rate of BAD diagnosis among patients with chronic diarrhea were found according to medical specialization. Gastroenterologists reported a higher prevalence of BAD compared with other physicians/general practitioners (1% vs 0.3%). BAD suspicion is mostly raised in the presence of watery stools and > 3 bowel movements/day and the exclusion of organic/drug-related diseases. BAD diagnosis was assessed with 75SeHCAT (67.8% of gastroenterologists and 51.4% of other physicians), followed by a trial of cholestyramine (30.5% of gastroenterologists and 31.4% of other physicians). Therapies most prescribed for BAD were cholestyramine, a low-fat diet, and stool thickeners. BAD is a common condition generally suspected in the presence of chronic watery diarrhea. 75SeHCAT availability influences the awareness of this disease. Therapies currently are often not able to guarantee adequate symptom relief.

• Publication year

  2025

• Venue

  Internal and Emergency Medicine

• Publication date

  2025-09-12

• Fields of study

  Medicine

• Identifiers
  DOI 10.1007/s11739-025-04060-9PMID 40938350PMCID 12534326
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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