Chronic Diarrhea Linked To Gallbladder Problems

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PEOPLE WITH chronic diarrhea--the kind that sends them to the bathroom so many times a day that it interferes with everyday activities--are often stymied in their efforts to stop the problem. Many find themselves visiting doctor after doctor in a constant, frustrating search to find out what's wrong. But a New Jersey gastroenterologist may have found a way to help.

Saad Habba, MD, studied 19 patients who were experiencing diarrhea anywhere from four to 10 times daily. A battery of tests to determine the cause of their trouble had yielded no clues. But the patients shared several factors in common, most notably that their diarrhea always occurred after meals-and was worse after fatty ones.

The syndrome was remarkably similar to the pattern of diarrhea some people develop after having their gallbladders removed. The gallbladder normally transfers a substance called bile, which works to digest fat, from the liver to the small intestine. But removing the gallbladder sends the bile directly from the liver into the intestine. Most people adapt to this change after several weeks, but in roughly one out of 10 cases there's an uncontrolled amount of bile secreted into the intestine-and it acts as a laxative.

In other words, the 19 patients in the study were "acting like people who didn't have gallbladders," Dr. Habba explains. Subsequent tests of their gallbladder function proved that it was indeed poor. So he gave them cholestyramine, a drug that's given to people to bind excess bile and remove it from the intestine, including after gallbladder removal. The drug stopped diarrhea within 24 hours in all 19 patients.

The overwhelming response to cholestyramine suggests that undiagnosed gallbladder problems may be responsible for many other cases of chronic diarrhea. But since the study was a small one, much more research must be done before the drug can be fully accepted as a treatment for the condition.

Did you know... One Nabisco Mini Oreo, the size of a quarter, has 16 calories. That makes a handful of 10 of them the caloric equivalent of three regular-size Oreos.

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