How to Treat Bile Acid Malabsorption: 5 Tips for Treating Bile Salt Malabsorption

Bile acid malabsorption (or bile salt malabsorption) can cause frequent diarrhea, abdominal cramps, bloating, and discomfort after eating. This condition can sometimes be chronic, significantly affecting daily life and quality of life if not properly managed.

Notably, bile acid malabsorption can be controlled by identifying the correct cause and choosing an appropriate treatment method. In this article, Tiptory helps you quickly understand what treating bile acid malabsorption involves, when to see a doctor, and which diet can help reduce diarrhea, abdominal pain, and discomfort. Experts also note that prolonged self-treatment should not replace medical diagnosis, as chronic diarrhea can stem from various causes.

Part 1: How to treat bile acid malabsorption with medication

Tip 1: Recognize bile acid malabsorption

See a doctor for prolonged or unusual diarrhea

• Diarrhea is a prominent symptom of bile acid malabsorption. Patients may experience frequent loose stools, sometimes pale, greasy, or foul-smsmelling. This condition can be persistent and significantly affect daily life.

• A notable sign is diarrhea that occurs quickly after eating. When bile acids are not fully absorbed in the small intestine and travel to the colon, they can stimulate water and electrolyte secretion and increase colonic motility, thereby causing diarrhea.

Pay attention to accompanying symptoms

• In addition to diarrhea, bile salt malabsorption can be accompanied by abdominal cramps, bloating, and excessive flatulence. Some people may experience significant discomfort after meals and constantly need to find a restroom, making work, school, or going out inconvenient.

• However, these symptoms are not sufficient to self-diagnose bile acid malabsorption. Chronic diarrhea can also be linked to irritable bowel syndrome with diarrhea, inflammatory bowel disease, celiac disease, microscopic colitis, infections, or other causes.

Especially note if you have Crohn's disease or IBS

• People with Crohn's disease, especially those with ileal damage or surgery, have a higher risk of bile acid diarrhea. A history of cholecystectomy should also be considered by doctors when evaluating chronic diarrhea.

• Irritable bowel syndrome with diarrhea (IBS-D) can also have symptoms very similar to bile acid malabsorption. Professional guidelines indicate that a significant percentage of people diagnosed with IBS-D may actually have bile acid diarrhea, so it should not be assumed that all cases of diarrhea are IBS.

See a doctor to determine the correct cause

• If you experience prolonged diarrhea, recurrent diarrhea after eating, abnormal stools, or persistent abdominal pain, consult a gastroenterologist instead of using anti-diarrhea medication for an extended period.

• The doctor may rely on medical history, symptoms, blood and stool tests to rule out other common causes. When bile acid diarrhea is suspected, some guidelines recommend specialized tests such as SeHCAT or a blood test for 7α-hydroxy-4-cholesten-3-one (C4) depending on the conditions of each country and healthcare facility.

• Determining the cause before initiating treatment for bile acid malabsorption is crucial. The British Society of Gastroenterology guidelines prioritize a "test and treat" approach rather than blindly trying bile acid binders, as not responding to the medication does not necessarily rule out the disease.

Do not ignore warning signs

• Seek early medical attention if diarrhea is accompanied by unintended weight loss, nighttime bowel movements, blood in stool, anemia, fever, severe abdominal pain, or worsening condition. These may be signs of another underlying medical condition that needs evaluation, rather than just being considered bile salt malabsorption.

• Correct diagnosis helps patients choose the appropriate treatment for bile acid malabsorption and avoids missing other gastrointestinal diseases with similar symptoms.

Tip 2: Tests to identify bile acid malabsorption

Undergo tests to diagnose the condition

• When bile acid malabsorption or bile salt malabsorption is suspected, the doctor may order tests to determine the cause of chronic diarrhea. Symptoms alone are often insufficient for an accurate diagnosis, so patients should undergo tests as directed rather than self-diagnosing.

• Some tests require several days or more for processing. Therefore, patients should be patient and wait for the results, and return for follow-up appointments so the doctor can evaluate all symptoms, medical history, and test results before choosing treatment for bile acid malabsorption.

SeHCAT test

• SeHCAT is a specialized test used to assess bile acid retention in the body. The patient ingests a labeled substance similar to bile acid, and its retention level is measured after about 7 days.

• If the retention rate is low, the result may suggest bile acid malabsorption. The degree of reduced retention can also help the doctor assess the severity of the condition.

• SeHCAT is commonly used in some European countries but is not routinely used in the United States. Therefore, the choice of test depends on the country, healthcare facility, and available resources.

7αC4 blood test

• The serum 7αC4 test measures the concentration of 7α-hydroxy-4-cholesten-3-one, an intermediate in the synthesis of bile acids in the liver. Elevated levels may suggest that the body is overproducing bile acids and supports the diagnosis of bile acid diarrhea.

• This is an alternative or complementary option to SeHCAT in places where SeHCAT testing is not available. However, the results need to be interpreted by a gastroenterologist in the context of symptoms and other tests.

48-hour stool test

• The doctor may request a 48-hour stool collection to assess the amount of bile acids excreted in the stool. Abnormally high bile acid levels can support the diagnosis of bile salt malabsorption.

• Patients need to collect samples at the correct time and according to the laboratory's instructions. This is an important factor because incomplete or incorrect sample collection can affect the reliability of the results.

Do not self-diagnose based on symptoms alone

• Post-meal diarrhea, loose stools, abdominal pain, and bloating can occur in various gastrointestinal conditions. Therefore, testing helps differentiate bile acid malabsorption from other causes of chronic diarrhea.

• After receiving the results, the doctor will combine the tests with medical history and symptoms to decide whether treatment for bile acid malabsorption is needed. Do not self-purchase bile acid binders or strictly change your diet before proper evaluation.

Tip 3: Bile acid binders help reduce diarrhea

Use bile acid binders as prescribed

• Bile acid sequestrants are one of the commonly used treatment methods when bile acid malabsorption causes diarrhea. This group of drugs binds to bile acids in the intestinal lumen, reducing the amount of free bile acids reaching the colon and thereby helping to limit their diarrheal effect.

• Cholestyramine is a commonly used drug in this group. Depending on the specific condition, the doctor may choose cholestyramine or another bile acid binder. The choice of drug and dosage should be based on the cause, severity of symptoms, and the patient's response.

Use medication correctly and for the full duration

• If prescribed medication to treat bile acid malabsorption, take it at the correct dose and time as directed by your doctor. Do not arbitrarily increase or decrease the dose or stop the medication just because diarrhea symptoms have subsided.

• Some bile acid binders come in powder form to be mixed and consumed. If it's difficult to take due to smell or texture, patients can ask their doctor or pharmacist about appropriate mixing methods. Do not arbitrarily mix the medication with food or drinks without checking the specific product's instructions for use.

Note interactions with other medications

• Bile acid binders can reduce the absorption of some oral medications and vitamins because they bind to substances in the digestive tract. Therefore, if you are taking other medications, provide a complete list of all medications, vitamins, and supplements to your doctor or pharmacist.

• Do not decide to take all medications at the same time. Your doctor or pharmacist can advise on the spacing between bile acid binders and other medications to minimize interactions.

Do not try medication to self-diagnose

• Previously, symptom improvement after taking bile acid binders was sometimes considered an indirect sign suggesting bile salt malabsorption. However, a response or lack of response to the medication should not be considered the sole evidence to confirm or rule out the disease.

• When feasible, doctors should evaluate the cause of diarrhea with medical history, appropriate tests, and specialized diagnostic methods before deciding on treatment for bile acid malabsorption. This approach helps avoid missing other gastrointestinal conditions with similar presentations.

Monitor response during treatment

• After starting medication, monitor bowel movement frequency, stool consistency, abdominal pain, and bloating. These changes help the doctor assess whether the medication is effectively controlling symptoms or if the treatment plan needs adjustment.

• If diarrhea persists, symptoms worsen, or if weight loss, dehydration, blood in stool, fever, or severe abdominal pain occur, seek re-evaluation to find the cause instead of self-increasing medication.

• The goal of treating bile acid malabsorption is not only to reduce diarrhea frequency but also to help patients maintain nutrition, normal daily activities, and long-term symptom control.

Tip 4: Reduce diarrhea in bile acid malabsorption

Anti-diarrhea medication can be used when needed

• If diarrhea persists despite treatment for bile acid malabsorption, the doctor may consider adding over-the-counter anti-diarrhea medications to control symptoms. Common medications include loperamide and bismuth subsalicylate.

• Anti-diarrhea medications only help reduce symptoms, they do not address the underlying cause of bile acid malabsorption. Therefore, they should not be used as a substitute for treating the cause or for prolonged self-use.

Use medication according to instructions

• For loperamide, use the dose indicated on the label or as prescribed by your doctor. Do not arbitrarily exceed the dose, as it can cause serious side effects, especially when using higher than recommended doses.

• For bismuth subsalicylate, carefully read the ingredients and warnings on the product. People allergic to aspirin/salicylates, taking anticoagulants, or with certain medical conditions should consult their doctor or pharmacist before use.

• If diarrhea does not improve after a short period of using over-the-counter medication, contact a healthcare professional to re-evaluate the cause instead of continuing self-treatment.

Be cautious when using with bile acid binders

• If you are taking cholestyramine or other bile acid binders for bile salt malabsorption treatment, ask your doctor or pharmacist before adding anti-diarrhea medication.

• Bile acid binders can affect the absorption of some oral medications. Therefore, the doctor may ask you to take other medications at different times to limit interactions.

Know when not to self-medicate

• Do not rely solely on anti-diarrhea medication if you have blood in your stool, high fever, severe abdominal pain, severe abdominal distension, signs of dehydration, or unusually prolonged diarrhea.

• In these cases, prioritizing medical examination to find the cause is important. Slowing bowel movements or masking symptoms in some intestinal diseases may not be appropriate.

The goal is control, not masking symptoms

• When bile acid malabsorption is properly controlled by addressing the cause, anti-diarrhea medications may only play a supportive role during periods of symptoms.

• Monitoring bowel movement frequency, stool consistency, and accompanying symptoms will help the doctor assess the effectiveness of bile acid malabsorption treatment and adjust the plan when necessary.

Tip 5: Be careful with supplements

Do not self-administer bile acid supplements

• People with bile acid malabsorption may find many products advertised to aid digestion or supplement bile acids. However, not all supplements are suitable, and some products may worsen diarrhea or other intestinal symptoms.

• In particular, self-supplementing with bile acids without clearly identifying the cause may not resolve bile salt malabsorption. Therefore, supplements should not be considered a substitute for medical-guided treatment for bile acid malabsorption.

Ask your doctor before taking any product

• Before using vitamins, minerals, herbs, or digestive support products, discuss them with your gastroenterologist or pharmacist. They can assess the benefits, risks, and potential interactions with current medications.

• Particular caution is needed if you are taking bile acid binders such as cholestyramine. These drugs can affect the absorption of certain medications and nutrients, so adding new products requires careful consideration of timing and dosage.

Provide a complete list of current medications

• When seeing a doctor for bile acid malabsorption, record all medications and products you are using, including prescription medications, over-the-counter medications, vitamins, minerals, and supplements.

• This list helps the doctor assess interaction risks and avoid selecting products that could worsen bile acid diarrhea or affect the effectiveness of treatment medications.

Prioritize evidence-based methods

• If you are looking for ways to treat bile acid malabsorption, prioritize methods that have been evaluated by a doctor and have clinical evidence, rather than chasing products advertised as "natural" or "detox."

• "Natural" does not mean "safe." For chronic diarrhea, the most important thing is to identify the correct cause, control symptoms, and avoid products that may cause more abnormal intestinal activity.

Part 2: Diet for people with bile salt malabsorption

Tip 1: Control underlying digestive diseases

Effectively treat co-occurring digestive conditions

• Bile acid malabsorption can be associated with several gastrointestinal conditions, especially Crohn's disease and conditions affecting the ileum. Therefore, if you have been diagnosed with an underlying digestive disease, good disease management is an important part of the plan to reduce symptoms.

• Irritable Bowel Syndrome with Diarrhea (IBS-D) can also present similarly or concurrently with bile acid diarrhea. Do not assume that all cases of diarrhea in people with IBS are due to a single cause.

Adhere to your doctor's treatment plan

• If you have Crohn's disease, irritable bowel syndrome, or celiac disease, take your medications and follow the diet as directed by your doctor.

• Do not stop taking medication on your own when symptoms have decreased. For chronic conditions, stable long-term control is often more important than just treating an acute symptom flare-up.

• Regular follow-up appointments help your doctor assess inflammation, nutrient absorption, and digestive symptoms to adjust treatment as needed.

Don't ignore recurrent diarrhea

• If you have controlled your underlying digestive disease but still frequently experience diarrhea after eating, abdominal cramping, bloating, or frequent bowel movements, discuss this with your doctor again.

• These symptoms may be related to bile salt malabsorption, medication side effects, diet, or another digestive condition. Identifying the correct cause will help select a more appropriate treatment for bile acid malabsorption.

Monitor to reduce the risk of symptom recurrence

• Record when diarrhea occurs, what foods you ate, the number of bowel movements, and any medications you are taking. This diary can help identify factors that worsen symptoms.

• The goal is not just to "stop" diarrhea for a few days but to control the underlying digestive disease and the cause of long-term diarrhea, thereby helping the patient maintain more stable daily activities and nutrition.

Tip 2: Avoid foods that worsen diarrhea

Monitor foods that may trigger symptoms

• With bile acid malabsorption, some people find that diarrhea, abdominal cramping, or bloating increases after eating certain foods. However, trigger foods are not the same for everyone, so you should not eliminate too many food groups at once on your own.

• Keep a record of what you eat, when you eat it, and any symptoms that appear afterward. This monitoring helps identify foods that may worsen bile acid diarrhea.

Prioritize a low-fat diet

• When bile salt malabsorption causes diarrhea, a low-fat diet may help some people reduce the severity of symptoms. A dietitian or doctor can advise on the appropriate amount of fat for your specific condition.

• Instead of completely eliminating fat, prioritize moderate portions and limit high-fat foods such as fried foods, fatty meats, creamy sauces, and processed foods with high oil content.

• Do not follow an excessively low-fat diet for an extended period without guidance, as fat is still essential for energy and the absorption of some fat-soluble vitamins.

Be cautious with foods that easily cause discomfort

• Some people may find symptoms increase after eating spicy foods, dairy and dairy products, garlic, high-gluten foods, or processed foods. However, this is not a mandatory list of foods to avoid for all people with bile acid malabsorption.

• If a specific food does not cause symptoms, there is no need to eliminate it just because it is often considered a "trigger food." The goal is to create a personalized diet that is nutritionally adequate and easy to maintain.

Eat more simply during periods of increased symptoms

• When experiencing significant diarrhea, prioritize simple meals with easily identifiable ingredients and avoid fatty dishes or those that have previously caused you discomfort.

• Eating at home during this period helps control ingredients and portions better, and makes it easier to identify which foods might be linked to symptoms.

Do not restrict your diet excessively on your own

• If you have to eliminate many food groups due to bile acid malabsorption, consult your doctor or a dietitian to avoid deficiencies in energy, protein, vitamins, and minerals.

• In particular, do not eliminate gluten long-term solely based on suspicion of bile salt malabsorption. If your doctor is evaluating you for celiac disease, stopping gluten before testing can affect diagnostic results.

Monitor to adjust your diet

• A simple food diary can record foods, portion sizes, meal times, number of bowel movements, and severity of abdominal pain or bloating. After a few weeks, this information can help your doctor or dietitian identify factors that need adjustment.

• Diet is only one part of treating bile acid malabsorption. If diarrhea persists despite dietary changes, the cause and treatment method need to be re-evaluated instead of continuing to restrict more and more foods.

Tip 3: Reduce fat to reduce diarrhea

Prioritize a low-fat diet

• For bile acid malabsorption, reducing the amount of fat in the diet may help limit symptoms for some people. When fat is consumed, the body increases bile acid secretion to aid fat digestion and absorption; if too much bile acid reaches the large intestine, diarrhea may become more pronounced.

• However, a strict limit of less than 40g of fat per day should not be applied to everyone. Research on low-fat diets for people with bile salt malabsorption shows that fat reduction interventions can improve stool frequency, loose stools, abdominal pain, and urgency, but the optimal fat intake still needs to be individualized.

Monitor fat intake in your diet

• During periods of increased symptoms, try reducing high-fat foods and monitor the number of bowel movements, stool consistency, abdominal pain, and bloating.

• Foods to limit include:

  • Fried foods and fast food.

  • Fatty meats, poultry skin, and processed meat products high in fat.

  • Butter, margarine, cream, and high-fat sauces.

  • Cakes, desserts containing a lot of butter or cream.

  • Processed foods with high fat content.

• Reading nutrition labels when buying packaged foods will help control fat intake more easily, instead of just relying on the feeling that a dish is "oily."

Do not completely eliminate fat

• Fat is still essential for the body, especially to provide energy and support the absorption of fat-soluble vitamins. Therefore, the goal of treating bile acid malabsorption through diet is to reduce fat intake appropriately, not to completely abstain from fat.

• When fat is needed, prioritize moderate portions from sources such as vegetable oils, fish, avocados, nuts, and legumes. However, even beneficial fats can increase symptoms if the total intake is too high.

Divide fat intake throughout the day

• Instead of consuming a lot of fat in one meal, distribute portions relatively evenly between meals. This approach can help reduce the amount of fat the body has to process at once and makes it easier to monitor which foods worsen symptoms.

• A food and symptom diary can be particularly helpful: record dishes, estimated fat content, meal times, number of bowel movements, and severity of abdominal pain or urgency.

Combine diet with medical treatment

• A low-fat diet can be part of bile acid malabsorption treatment, but it may not always be enough to control symptoms. Professional guidelines suggest that individuals with mild conditions may benefit from a low-fat diet; moderate or severe cases, or those who respond poorly to dietary changes, may require prescribed bile acid binders.

• If you have reduced fat intake reasonably but still experience significant diarrhea, post-meal diarrhea, or urgency, revisit your doctor instead of continuing to cut out more foods. Excessive dietary restriction can lead to an unbalanced diet and may not necessarily address the underlying cause.

Personalize the diet for long-term control

• There is no single diet that works for everyone with bile acid malabsorption. The degree of fat restriction should be adjusted according to symptoms, nutritional status, co-existing conditions, and response to treatment.

• If you need to maintain a low-fat diet for a long time, you should discuss it with your doctor or a dietitian to ensure you are still getting enough energy and essential vitamins and minerals. This is a more practical approach than applying a fixed number like "40g of fat per day" for all cases.

Tip 4: Supplement vitamin B12 for malabsorption

Monitor the risk of vitamin B12 deficiency

• Individuals with bile acid malabsorption may be at risk of vitamin B12 deficiency, especially when the condition involves the ileum – the part of the small intestine where both vitamin B12 and bile acids are absorbed. Some patient guidelines also note B12 deficiency in people with bile acid diarrhea.

• Not every case of bile salt malabsorption necessarily causes B12 deficiency. The risk depends on the cause and extent of ileal damage or resection, Crohn's disease, and co-existing digestive conditions.

Check vitamin B12 when at risk

• If you have a condition affecting the ileum or symptoms suggestive of B12 deficiency such as fatigue, weakness, numbness, balance issues, or memory problems, discuss blood tests for vitamin B12 with your doctor.

• Do not take high doses of vitamin B12 on your own just because you have been diagnosed with bile acid malabsorption. Testing and evaluating the cause helps determine if you actually have a vitamin deficiency and whether oral supplementation or another method is needed.

Prioritize B12-rich foods

• If absorption capacity is still good, B12 can be supplemented through a balanced diet. Food sources rich in vitamin B12 include:

  • Fish and shellfish.

  • Beef and other meats.

  • Eggs.

  • Milk and dairy products.

  • Foods fortified with vitamin B12, such as some cereals and plant-based beverages.

• If you are experiencing bile acid diarrhea, do not try to eat too many high-fat foods just to increase B12. Choose B12 sources compatible with a low-fat diet if this approach is recommended by your doctor or dietitian.

Supplement vitamin B12 when truly necessary

• If tests show vitamin B12 deficiency, your doctor may prescribe supplemental vitamin B12 at an appropriate dose and administration method. Supplementation should be based on the degree of deficiency, the cause, and the individual's absorption capacity.

• Digestive conditions causing malabsorption, such as Crohn's disease or celiac disease, can increase the risk of B12 deficiency. In these cases, simply increasing B12-rich foods may not be enough to correct the deficiency.

Note vitamins A, D, E, and K when taking bile acid binders

• If you are treating bile acid malabsorption with bile acid binders like cholestyramine or colesevelam long-term, be aware of the risk of reduced absorption of fat-soluble vitamins A, D, E, and K.

• Some medical facilities recommend considering vitamin checks and using multivitamins, especially A, D, E, and K, when taking bile acid binders for extended periods. However, do not self-supplement with high doses, as the need for supplementation should be based on tests and your doctor's evaluation.

Take vitamins at the right time if using cholestyramine

• Cholestyramine can reduce the absorption of concurrently taken medications, vitamins, and minerals. Therefore, if you are prescribed cholestyramine, ask your doctor or pharmacist about the necessary time interval between this medication and vitamins and other drugs. Some hospital guidelines recommend taking other medications or vitamins at least 1 hour before or 4 hours after cholestyramine.

• This is a particularly important point when developing a long-term bile salt malabsorption treatment plan: not only controlling diarrhea but also monitoring nutritional status and the risk of micronutrient deficiencies when indicated.

Prioritize testing over self-supplementation

• The goal of vitamin supplementation in bile acid malabsorption is to replenish the specific nutrients that are deficient, not to use as much as possible. If you need to take bile acid binders long-term or have an ileal condition, discuss checking B12 and fat-soluble vitamins with your doctor as appropriate.

• This approach helps the treatment of bile acid malabsorption both control diarrhea and limit the risk of nutritional deficiencies during treatment.

Tip 5: When to see a dietitian

Seek professional help to create a suitable diet

• Diet can play an important role in managing bile acid malabsorption and bile acid diarrhea. However, individual nutritional needs and food sensitivities vary. If you find it difficult to adjust your diet on your own, consider working with a dietitian specializing in gastrointestinal conditions.

• Instead of following a fixed list of restrictions, a specialist can help create a meal plan based on your symptoms, tolerated fat intake, co-existing digestive conditions, weight, and energy needs.

Monitor and adjust your diet step by step

• A dietitian can guide you to:

  • Determine the appropriate amount of fat to reduce diarrhea while ensuring adequate energy.

  • Choose nutrient-dense foods that are less likely to irritate the digestive tract.

  • Monitor foods that may increase abdominal pain, bloating, or diarrhea.

  • Ensure your diet still provides enough protein, vitamins, and minerals.

  • Adjust your diet if you also have Crohn's disease, irritable bowel syndrome, celiac disease, or other digestive conditions.

• A food and symptom diary can also help the specialist identify the link between meals and symptoms, thereby avoiding unnecessary food eliminations.

Prioritize specialists with appropriate expertise

• When seeking advice, choose a dietitian who is trained and licensed or certified to practice according to the regulations in your place of residence, especially if you need advice for a digestive condition.

• You can ask your treating doctor for a referral to a dietitian experienced in bile acid malabsorption, chronic diarrhea, or intestinal diseases.

Consider seeking advice, especially when restricting many foods

• If you have to limit many food groups, are losing weight, have difficulty eating, or are concerned about vitamin and mineral deficiencies, consulting a dietitian is even more valuable.

Combining Nutrition with Medical Treatment

• A nutritionist does not replace a doctor in diagnosing or prescribing medication. With bile acid malabsorption, an effective plan often requires coordination between diagnosing the cause, medication when indicated, and dietary adjustments.

• If diarrhea persists despite dietary changes, revisit your doctor to re-evaluate the cause. Do not continue to restrict more and more foods just because you think "eating less will stop the diarrhea"; an overly restricted diet can lead to energy and nutrient deficiencies in the body.

References

1. Sadowski DC, Camilleri M, Chey WD, Leontiadis GI, Marshall JK, Shaffer EA, Tse F, Walters JR. Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea. Journal of the Canadian Association of Gastroenterology. 2020;3(1):e10–e27. doi:10.1093/jcag/gwz038.
2. Sadowski DC, Camilleri M, Chey WD, Leontiadis GI, Marshall JK, Shaffer EA, Tse F, Walters JR. Canadian Association of Gastroenterology Clinical Practice Guideline on the Management of Bile Acid Diarrhea. Clinical Gastroenterology and Hepatology. 2020;18(1):24–41.e1. doi:10.1016/j.cgh.2019.08.062.
3. Jackson A, Lalji A, Kabir M, Muls A, Gee C, Vyoral S, Shaw C, Andreyev J. The efficacy of using low-fat dietary interventions to manage bile acid malabsorption. Gut. 2017;66(Suppl 2):A114.1. doi:10.1136/gutjnl-2017-BSGAbstracts.220.
4. Jackson A, Lalji A, Kabir M, Muls A, Gee C, Vyoral S, Shaw C, Andreyev J. Management of bile acid malabsorption using low-fat dietary interventions: a useful strategy applicable to some patients with diarrhoea-predominant irritable bowel syndrome? Clinical Medicine. 2025;15(6):536. doi:10.7861/clinmedicine.15-6-536.
5. Practices, Attitudes, Perceived Knowledge, and Intentions Underlying Low-Fat Dietary Behaviours in Adults Living With Bile Acid Diarrhoea: A Cross-Sectional Study. Journal of Human Nutrition and Dietetics. 2026.
6. Canadian Association of Gastroenterology. Clinical Practice Guidelines and Consensus Reports: Management of Bile Acid Diarrhea. Canadian Association of Gastroenterology; 2019.

Content edited by: Rowan Hudson Le.

Information consulted and verified by expert: Olivia Thompson.