Original articleAlimentary tractIncreased Bile Acid Biosynthesis Is Associated With Irritable Bowel Syndrome With Diarrhea
Section snippets
Participants
The study was reviewed and approved by Mayo Clinic's Institutional Review Board, and each participant provided signed informed consent. From a cohort of approximately 700 previously genotyped IBS patients (based on Rome II criteria) and healthy volunteers (HV), we invited 78 randomly selected participants: 26 HV, 26 IBS-C, and 26 IBS-D patients. These sample sizes were expected to provide approximately 80% power (based on a 2-sample t test using a 2-sided α level of .05 to detect the effect
Participant Demographics
Table 1 shows the age, body mass index (BMI), and estimated daily fat intake during the study for each of the 3 subgroups. Previous cholecystectomy was recorded in 23% of IBS-D, approximately 4% of IBS-C, and approximately 4% of HV (P = .05). All patients' symptoms anteceded the cholecystectomy and were confirmed by study subjects as not significantly aggravated or changed by subsequent cholecystectomy.
BMI was associated with subgroup (overall P = .036 where the BMI in IBS-D was approximately 4
Discussion
This study demonstrates that IBS-D patients, unselected for clinical response to BA binding, have evidence of higher hepatic BA synthesis and stool BA excretion compared with control subjects and patients with IBS-C. In IBS-D, the upper quartile for 48-hour stool weight and fat were, respectively, 481 g and 8 g, and the 90th percentile for stool fat was 15 g/48 hours. These data suggest that about 25% of IBS-D patients had increased 48-hour stool weight, but that the stool fat was within the
Acknowledgments
The authors thank Mrs Cindy Stanislav for excellent secretarial assistance.
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Conflicts of interest The authors disclose no conflicts.
Funding This study was supported in part by NIH grants 1RC1-DK086182 and R01-DK092179 (to Dr Camilleri).