Journal Article Effect of the Bile Acid-Binding Resin Colestimide in Refractory Bile Acid Malabsorption in Patients with Chronic Diarrhea

Hiroaki, Zai  ,  Toshiyasu, Watanabe  ,  Naoyuki, Kawagoe  ,  Ikutaka, Takemoto  ,  Hideki, Tanaka  ,  Sho Kijima  ,  Tadashi, Maeda  ,  Taito, Miyazaki  ,  Yoshihisa, Urita  ,  Hitoshi, Nakajima

2 ( 2 )  , pp.61 - 66 , 2016-6 , The Medical Society of Toho University
Background: Recent reports indicate that bile acid malabsorption is present in about 30% of patients with chronic diarrhea and a diagnosis of diarrhea-predominant irritable bowel syndrome (IBS-D) and that treatment with bile acid-binding resin is effective. We investigated the effects of colestimide on refractory chronic diarrhea in IBS-D. Methods: Twenty-eight patients with refractory IBS-D or chronic diarrhea were enrolled and treated with colestimide. Fifteen had no past history of gastrointestinal surgery and 13 had undergone such surgery. Small intestinal bacterial overgrowth (SIBO) was also evaluated by lactulose breath testing in 21 patients. All patients were given 1500 mg of colestimide twice a day for 2 weeks, after which the effects of colestimide treatment were evaluated. Results: Of the 21 patients examined for SIBO, 8 (38.1%) had a positive result. Prevalence of SIBO was not associated with past surgical history (p=0.472). In 21 (75.0%) of the 28 patients, colestimide improved diarrhea and bowel habits (p=0.008). The effectiveness of colestimide was not associated with past surgical history or presence of SIBO. Conclusions: Colestimide treatment had a satisfactory effect for chronic diarrhea potentially attributable to bile acid malabsorption. The effectiveness of empirical administration of colestimide for patients with refractory chronic diarrhea and IBS-D should be assessed in a future study.

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