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   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Thousands suffer from tabooed disease: New method makes it easier to   
   identify the right treatment    
      
     Date:   
         July 5, 2023   
     Source:   
         University of Copenhagen - The Faculty of Health and Medical   
         Sciences   
     Summary:   
         More than 10 urgent visits to the bathroom a day due to diarrhea   
         can make it virtually impossible to lead a normal life. But new   
         research can help doctors diagnose bile acid diarrhea and find   
         the right treatment.   
      
      
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   Most people have at some point in their life suffered an intestinal   
   infection or food poisoning forcing them to stay close to the bathroom. It   
   is very uncomfortable. Most of the time, though, it passes quickly.   
      
   But around 60,000-100,000 Danes suffer from a form of chronic diarrhea   
   called bile acid malabsorption or bile acid diarrhea.   
      
   It is a chronic condition characterised by frequent and sudden diarrhea   
   more than 10 times a day. Even though the disease is not life-threatening,   
   it can seriously affect the patient's everyday life, especially their   
   social life, and be extremely disabling.   
      
   "You have to rush to the bathroom several times a day. Therefore,   
   keeping a job or maintaining social relations can be difficult, and a   
   lot of people isolate themselves. The disease controls their life,"   
   says Professor Jesper Bo/je Andersen from the Biotech Research &   
   Innovation Centre.   
      
   He and his research group and clinical cooperation partners at Herlev   
   and Gentofte Hospital headed by Professor and Consultant Doctor Filip   
   Krag Knop are responsible for a new study, which provides new ways   
   of diagnosing bile acid diarrhea and identifying the most effective   
   treatment for the individual patient.   
      
   "A lot of people with chronic diarrhea don't realise 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 Filip Krag Knop.   
      
   Jesper Bo/je Andersen adds: "We have developed a new concept which may   
   be used to diagnose the disease based on a simple blood sample. Today,   
   diagnostics involves radiopharmaceuticals, which means that there is a   
   radiation risk. The process is not necessarily dangerous, but unpleasant   
   and arduous, and not all countries in the world support the method,   
   including the US."  The new method means that doctors should be able to   
   determine whether the patient has bile acid diarrhea based on a simple   
   blood sample. They focus on molecules known as metabolites in the blood.   
      
   "A blood sample contains lots of different metabolites. Right now we are   
   able to identify almost 1,300 different metabolites, and around a handful   
   of these can be used to diagnose bile acid diarrhea. The metabolites of   
   bile acid diarrhea patients form a particular pattern that makes them   
   recognisable," says Jesper Bo/je Andersen.   
      
   Which treatment?  The researchers analysed blood samples from 50 patients   
   and they quickly realised that the samples -- and patients -- could be   
   divided into two groups.   
      
   "First, we did not understand why. All the blood samples had been taken   
   before treatment, typically at the time of diagnosis," says Jesper   
   Bo/je Andersen.   
      
   The patients then participated in a randomised clinical study at   
   the Center for Clinical Metabolic Research at Herlev and Gentofte   
   Hospital. Here the doctors studied the effect of two different treatments:   
   the conventional treatment involving bile acid sequestrant colesevelam   
   and a new treatment involving liraglutide, which is normally used to   
   treat 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. This suggests that we should   
   be able to say which treatment is the most effective by analysing the   
   patient's blood at the time of diagnosis," says Jesper Bo/je Andersen.   
      
   The clinical study showed that colesevelam treatment eased the bile   
   acid diarrhea symptoms of 50 per cent of the patients, while liraglutide   
   treatment eased the symptoms of 77 per cent of the patients.   
      
   Jesper Bo/je Andersen, Filip Krag Knop and their research groups hope   
   the new study will benefit the 60,000-100,000 Danes who suffer from bile   
   acid diarrhea.   
      
   The majority of cases of bile acid diarrhea is diagnosed at a very late   
   stage or never diagnosed at all.   
      
   "Around 40 per cent 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 realise that it is a disease and that it can be treated. But it   
   may also be because chronic diarrhea is a tabooed disease," says Filip   
   Krag Knop.   
      
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   Worthy_of_a_Toast Story Source: Materials provided by   
   University_of_Copenhagen_-_The_Faculty_of_Health_and   
   Medical_Sciences. Note: Content may be edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Monika Lewinska, Martin Lund Kaarhus, Anne-Marie Gade Ellegaard,   
      Manuel   
         Romero-Go'mez, Rocio I R Macias, Jesper B Andersen, Filip Krag Knop.   
      
         Serum lipidome unravels a diagnostic potential in bile acid   
         diarrhoea.   
      
         Gut, 2023; gutjnl-2022-329213 DOI: 10.1136/gutjnl-2022-329213   
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   Link to news story:   
   https://www.sciencedaily.com/releases/2023/07/230705122451.htm   
      
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