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COPENHAGEN, Denmark — Intestinal infections and food poisoning are no fun, but they typically pass quickly. For some people, chronic diarrhea is a daily struggle. Researchers from the University of Copenhagen say 60,000 to 100,000 Danes suffer from a condition called bile acid malabsorption or bile acid diarrhea, which causes frequent and sudden bouts of diarrhea over 10 times a day. Now, a new study has found a medical method that could revolutionize the diagnosis of chronic diarrhea and make it easier to treat.

“A lot of people with chronic diarrhea don’t realize that they suffer from bile acid diarrhea and what has caused it. This is a result of lack of knowledge among healthcare workers and the relatively complex and expensive – and for the patient difficult – process of diagnosing the disease,” says Professor Filip Krag Knog in a university release.

Researchers say instead of relying on radiation-based radiopharmaceuticals, their method involves analyzing metabolites in a simple blood sample. By examining the distinct pattern of metabolites related to bile acid diarrhea, doctors can accurately diagnose the condition.

Figuring sitting on toilet paper roll
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In addition to the diagnostic breakthrough, the study also shed light on the most effective treatment options for patients. Through a randomized clinical study, the researchers divided patients into two groups based on the metabolites present in their blood samples. They discovered that different treatments were more beneficial for each group. The conventional treatment involving bile acid sequestrant colesevelam proved effective for one group, while the other group responded well to liraglutide, a medication typically used for Type 2 diabetes and severe overweight.

“What is interesting is that the metabolites in the patients’ blood divided them into two groups: one that responds well to colesevelam and one that responds well to liraglutide,” Professor Jesper Bøje Andersen, from the Biotech Research & Innovation Centre, emphasizes. “This suggests that we should be able to say which treatment is the most effective by analyzing the patient’s blood at the time of diagnosis.”

The clinical study demonstrated that colesevelam eased symptoms in 50 percent of the patients, while liraglutide provided relief for 77 percent of the patients.

The researchers hope that this breakthrough study will benefit the thousands of Danes suffering from bile acid diarrhea, as the majority of cases go undiagnosed or are diagnosed at a very late stage.

“Chronic diarrhea is a tabooed disease,” says Knop. “Around 40% of the patients suffer from this condition for up to five years before it is diagnosed. Of course, this may be because they do not realize that it is a disease and that it can be treated.”

Researchers note that the findings of this study provide hope for improved diagnosis and targeted treatment options, offering relief and a better quality of life for those affected by bile acid diarrhea.

The study is published in the journal Gut.

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