#15 Understanding bile acid diarrhoea / malabsorption in IBD with Professor Julian Walters

Bile acid diarrhoea and bile acid malabsorption, particularly in relation to IBD patients, are discussed with Professor Julian Walters of Imperial College London. The conversation clarifies the distinction between bile acid malabsorption and diarrhoea, noting the terminal ileum's role in bile acid reabsorption and how its dysfunction, common in Crohn's patients, leads to malabsorption. The discussion covers diagnostic methods like the SeHCAT test and alternative blood tests, treatment options including bile acid sequestrants versus loperamide, and the importance of dietary modifications. Additionally, the potential of new treatments such as GLP-1 receptor agonists and INSL-5 are explored, alongside the need for greater awareness among healthcare professionals regarding bile acid diarrhoea's prevalence and impact.