Bile Acids: An Underrecognized and Underappreciated Cause of Chronic Diarrhea

Bile acid malabsorption is a common cause of chronic watery diarrhea; however, its role appears to be poorly appreciated among clinicians. As such, bile acid diarrhea remains an underrecognized cause of chronic diarrhea, resulting in many patients incorrectly diagnosed and interfering and delaying proper treatment. In this review, we briefly discuss the synthesis, enterohepatic circulation, and function of bile acids. We then focus on the role of bile acids in bile acid malabsorption including the diagnostic and treatment options. By recognizing that bile acid malabsorption is a relatively common cause of chronic diarrhea, we hope that more physicians will more effectively evaluate and treat patients with this condition.