Prevalence of bile acid diarrhoea in non-alcoholic liver diease
Research type
Research Study
Full title
Prevalence of primary bile acid diarrhoea in non-alcoholic liver diease
IRAS ID
172268
Contact name
Julian Walters
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
0 years, 6 months, 16 days
Research summary
Bile acid diarrhoea (BAD) causes chronic diarrhoea, pain and bloating in as many at 1% of the population. In 2009 our research group established a link between low amounts of the ileal hormone, fibroblast growth factor 19 (FGF19) and primary (idiopathic) BAD. Low FGF19 has since been shown to be associated with obesity, high serum triglycerides and non-alcoholic liver disease in children. We speculate that there is a metabolic syndrome of low FGF19 of which NAFLD and pBAD are symptoms. Primary BAD is usually diagnosed by administering 75Selenium –homocholic acid taurine (SeHCAT) and measuring the whole body retention 7 days later. This is a widely accepted clinical test, but is under performed. A retrospective analysis of 174 patients with chronic diarrhoea at our centre found an increased prevalence of NAFLD in patients with a SeHCAT retention <15% compared to those with normal SeHCAT retention. (odds ratio of 2.5, p<0.001). In the UK 33% of adults have NALFD and about 5% have the more severe stage of Non-alcoholic steatohepatitis. Proving a link between NAFLD and pBAD will help us understand the pathogenesis of both conditions and may allow for earlier recognition of patients with diarrhoea and NAFLD. In our NHS trust patients with suspected NAFLD are referred to a multi-disciplinary clinic by GPs or specialists. We propose to ask patients about their bowel habit in clinic and if they report diarrhoea, ask them to complete a stool diary for 1 week. Those who report >21 stools/week will offered a SeHCAT retention scan (as per current clinical guidance). All patients will be asked for an additional fasting blood sample for FGF19, which may be taken at the same time as the routine clinical blood test, or may be taken separately. All data will be anonymised before being entered onto a database.
REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
15/EM/0082
Date of REC Opinion
11 Feb 2015
REC opinion
Further Information Favourable Opinion