Published: 27 July 2024
Author(s): Agostino Di Ciaula, Mohamad Khalil, Gyorgy Baffy, Piero Portincasa
Section: Invited Review Article

Excessive biosynthesis or secretion of bile acids (BAs) and their malabsorption (BAM) in the terminal ileum or the colon [1] generates chronic diarrhoea (cholorrhea). This symptom depends on a dysregulation in the enterohepatic circulation of BAs (Fig. 1) and, in turn, on relative abundance of BAs in the lower gastrointestinal tract, with abnormal transport of water and sodium, mucosal damage, increased mucus secretion and intestinal motility, gut dysbiosis [2,3]. Symptoms like urge of defecation [4–7], fecal incontinence [8], fatigue, dizziness, and fainting feeling [9] in BAM may lead to depression and poor quality of life [8,10].

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