New blood test may diagnose bile acid diarrhea

Most people have suffered from intestinal infections or food poisoning at some point in their lives that forced them to go to the bathroom. Very uncomfortable. However, most of the time it passes quickly.

However, about 60,000 to 100,000 Danes suffer from a form of chronic diarrhea called bile acid malabsorption or bile acid diarrhea.

It is a chronic disease characterized by frequent and sudden diarrhea 10 or more times a day. Although the disease is not life-threatening, it can severely affect a patient’s daily life, especially social life, and cause extreme disability.

I have to run to the bathroom multiple times a day. This makes it difficult to keep a job and maintain social relationships, and many become isolated. Illness rules their lives. ”

Professor Jesper Bøje Andersen, Center for Biotechnology Research and Innovation

He, his research group, and clinical collaboration partners at the Herlef Gentofte Hospital, led by Professor and Consultant Physician Philip Krag Knopp, have developed new methods to diagnose bile acid diarrhea and identify the most effective treatments for individual patients. I am in charge of new research that provides

“Many people with chronic diarrhea do not understand that they are suffering from bile acid diarrhea and why. It’s the result of a difficult process for the patient, about the importance of diagnosing the disease,” says Philip Crag-Knopp.

Jesper Bohe Andersen adds:

“We have developed a new concept that can be used to diagnose disease based on a simple blood sample. Today, diagnostics involve radiopharmaceuticals, which means there is a radiation risk. The process is not necessarily dangerous, but it is uncomfortable and difficult, and not all countries in the world, including the United States, support this method.”

This new method means that doctors can determine whether a patient has bile acid diarrhea based on a simple blood sample. They focus on molecules known as metabolites in the blood.

“Blood samples are rich in different metabolites. Currently, we are able to identify about 1,300 different metabolites, of which only a handful can be used to diagnose bile acid diarrhea. Metabolites in patients with bile acid diarrhea form a particular pattern, they are familiar,” says Jesper Boye Andersen.

Which treatment?

The researchers analyzed blood samples from 50 patients and quickly found that the samples and patients could be divided into two groups.

“First, we didn’t know why. All blood samples were taken before treatment, usually at diagnosis,” says Jesper Borje Andersen.

The patient then participated in a randomized clinical study at the Center for Clinical Metabolic Research at the Gerleb Gentofte Hospital. Here, doctors report the effects of two different treatments: a conventional treatment using the bile acid sequestrant colesevelam and a new treatment using liraglutide, which is commonly used to treat type 2 diabetes and severe overweight. studied.

“What is interesting is that the metabolites in the blood of the patients divided them into two groups: one group that responded well to colesevelam and the other group that responded well to liraglutide. It suggests that we should be able to say which treatment is most effective by doing the “patient’s blood at the time of diagnosis,” says Jesper Boye-Andersen.

This clinical study showed that colesevelam treatment relieved symptoms of bile acidic diarrhea in 50 percent of patients, and liraglutide treatment relieved symptoms in 77 percent of patients.

Jesper Bøje Andersen, Filip Krag Knop and their research group hope that the new research will benefit the 60,000 to 100,000 Danes who suffer from bile acid diarrhea.

Most cases of bile acid diarrhea are diagnosed very late or not diagnosed at all.

“About 40 percent of patients suffer from the condition for up to five years before being diagnosed. Of course, this may be because patients do not realize it is a disease and can be treated. But it could also be the cause,” says Philip Krag-Knopp, “because chronic diarrhea is a taboo disease.”