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Dr. Barbara Bolen

Potential Medication for Bile Acid Diarrhea

By June 6, 2013

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Yesterday, I discussed some news coming out of the 2013 Digestive Disease Week (DDW) about a new IBS-D drug. Another press release caught my eye and made me sit up straight in my chair! Okay, that is a bit of an exaggeration, but the press release discussed a topic that I have recently covered - one that has not received a tremendous amount of research attention - that of diarrhea after eating in IBS. Regular readers will remember that I covered the topic in this article:

In the article, I discuss a theory promoted by some researchers regarding the role of bile acid malabsorption in diarrhea that occurs after eating, otherwise known as postprandial diarrhea. So you can understand why a press release discussing something called "bile acid diarrhea" would catch my eye. According the press release, "primary bile acid diarrhea" (PBAD) is another name for "idiopathic bile acid malabsorption" and they estimate that it is responsible for approximately one third of all cases of IBS-D. I must speak up here and note that this is a press release and not a scholarly journal that I am quoting from, so we can draw no conclusions about the validity of these statements.

Things do get even more interesting. The company is currently testing a potential medication for this condition - a medication they are calling obadiah. Obadiah is comprised of obeticholic acid (OCA) and is currently in ongoing Phase II clinical trials. The theory behind the medication is that PBAD patients have low levels of a certain hormone that regulates liver bile production, causing too much bile acid to enter the small intestine, resulting in diarrhea. The medication is thought to increase the release of that hormone, thus better regulating the flow of bile acid.

For those of you who find that you are running to the bathroom soon after eating, research along these lines may result in some helpful treatment options. In the meantime, please be sure to read the above article to get some ideas for treatment options that are available now. I will keep my eye out for any additional information about obadiah as it progresses its way through the drug approval process.

Related Reading from Dr. Bolen, Your IBS Guide

Sources:

"Intercept Pharmaceuticals Announces Positive Initial Results from Ongoing Phase 2a Trial in Chronic Bile Acid Diarrhea" PR Newswire May 20, 2013.

"Potential Use of OCA to Treat Bile Acid Diarrhea" Intercept Pharmaceuticals Website Accessed May 26, 2013.

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