Chronic diarrhoea presents a difficulty in diagnosis

Persistent chronic diarrhoea is a problem in clinical practice that is often difficult to diagnose and treat.¹

1 in 20 people may suffer from chronic diarrhoea, making it one of the commonest referrals to a GI clinic.²

More specifically it affects 3 million people in the UK and the total prevalence of chronic diarrhoea in a Western population is estimated in 4-5%.³

Diagnostic difficulty often leads to numerous visits to doctors and clinics, with investigations which may not lead to a definitive diagnosis .³

There can be multiple causes for chronic diarrhoea including Irritable bowel syndrome (IBS), Inflammatory bowel disease (IBD), Bile Acid Diarrhoea (BAD).¹

Adapted from Smith MJ et al (2000)¹

BAD is a common cause of chronic diarrhoea affecting a large population

BAD is the diarrhoea caused by bile acids and has historically been referred to as bile acid malabsorption.⁴

The data below show the number of patients presenting with chronic diarrhoea who were shown to have underlying BAM⁵

The prevalence in chronic diarrhoea is high, as a recent study indicated that the main cause of this diarrhoea was IBS, while diarrhoea caused by Bile Acid (SeHCAT retention <15% at 7 days) was the fourth leading cause⁶.

Thus, BAD can be very common, affecting 1 % of the general population, which equates to approximately 10 million people in North America and Europe alone. ⁷

References:
1. Smith MJ et al. J R Coll Physicians Lond 2000; 34 (5): 448-51.
2. Thomas PD et al. Gut 2003; 52: 1-15.
3. NICE diagnostics guidance [DG7] 2012.
4. Mottacki N et al. Alliment Pharmacol Ther 2016; 43 (8): 884-98.
5. Basumani et al. Bile Acid Malabsorption: Two Decades On. Gut 2008; 57 (Suppl I): A1-A172.
6. Kurien M, Chaudhary S, McConnell JR, Leeds JS, Sanders DS. Pharmacol Ther. 2014 Jul;40(2):215.
7. Gupta A et al. Support Care Cancer 2015 1-10

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