What Is Habba Syndrome?
Habba Syndrome is a term coined by Saad F. Habba, M.D. Dr. Habba has postulated the theory that diarrhea-predominant IBS (IBS-D) and functional diarrhea are catch-all terms for other identifiable medical conditions. According to Dr. Habba, one potential cause of these diarrhea symptoms would be that of a gallbladder that is intact but dysfunctional. It is this gallbladder dysfunction that he has labeled as "Habba Syndrome."
Who Is Dr. Habba?
According to Dr. Habba's web site, he is a gastroenterologist with over thirty years of experience. He currently maintains a private practice in New Jersey and is a Clinical Assistant Professor at the Mount Sinai School of Medicine.
Dr. Habba has based his theory on one study that he conducted in which he took a retrospective look at patients in his own practice. The study included a total of 303 patients who were diagnosed with IBS-D or functional diarrhea and who experienced their symptoms postprandial. Of this group, he identified 41% of these patients as having Habba Syndrome, while another 23% experienced symptoms following the removal of their gallbladders.
Related research has looked at a condition called bile acid malabsorption (BAM). Studies have shown that BAM may be what is behind some cases of IBS-D. Authors of a review on the subject have recommended that BAM be considered by doctors when evaluating IBS-D cases.
Symptoms of Habba Syndrome
Dr. Habba's theory describes the symptoms of Habba Syndrome as consisting of chronic diarrhea that predominately occurs after meals. Symptoms must be present for at least three months. Diarrhea is often urgent, explosive, and may result in incontinence. In Dr. Habba's syndrome, diarrhea rarely happens at night.
Diagnosis of Habba Syndrome
Dr. Habba recommends a full diagnostic work-up to rule out other digestive disorders. He then recommends hepatobiliary scintigraphy, a nuclear medicine test, to determine the functioning level of the gallbladder, as quantified by a measure called the ejection fraction.
Treatment of Habba Syndrome
Dr. Habba uses "bile acid binding agents" to treat the identified gallbladder dysfunction. Medications in this class include:
- Cholestyramine (Questran)
- Colesevelam (WelChol)
- Colestipol (Colestid)
The Bottom Line
There is an old saying "one swallow does not a summer make" that is very fitting here. One study does not a syndrome make. While I applaud anyone who is "thinking out of the box" and trying to come up with new and improved treatment option for IBS, unbiased studies, using placebo control groups, are absolutely needed before anyone can claim the existence of "Habba Syndrome". Although Dr. Habba's research methodology is lacking, he does report an extremely high success rate with the use of bile acid binding agents within his own practice.
Hopefully continued research as to the role of BAM will be conducted to verify the safety and effectiveness of Dr. Habba's approach to the treatment of the symptoms of IBS-D and functional diarrhea.
Essential Reading from Dr. Bolen, your IBS Expert:
- I-BAM and IBS-D
- IBS and Gallbladder Problems
- IBS After Gallbladder Removal
- IBS Diarrhea After Eating
Wedlake, L., et.al. "Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome" Alimentary Pharmacology and Therapeutics 2009 30:707-717.
Habba, S. "Diarrhea Predominant Irritable Bowel Syndrome (IBS-D): Fact or fiction" Medical Hypotheses 2011 76:97-99.
habbasyndrome.com Accessed February 23, 2011.
DISCLAIMER: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis or treatment rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.