ReviewCureus2026
Primary Bile Acid Diarrhea: A Narrative Review of Pathophysiology, Diagnostic Challenges, and Emerging Therapeutic Strategies.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Real-world management of SeHCAT-confirmed bile acid diarrhoea: response to colestyramine and predictors of treatment success.Gastroenterology report · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Primary bile acid diarrhea (BAD) is a clinically relevant cause of persistent watery diarrhea caused by high bile acid production and poor enterohepatic feedback regulation. A growing body of evidence suggests that disrupting the farnesoid X receptor-fibroblast growth factor 19 (FXR-FGF19) signaling pathway contributes to aberrant bile acid metabolism and increased colonic output. Despite increased understanding of its link with diarrhea-predominant irritable bowel syndrome (IBS-D), primary BAD remains difficult to diagnose due to overlapping clinical symptoms and a scarcity of specialist diagnostic tools. This narrative review highlights current data on the pathogenesis, clinical presentation, diagnostic modalities, and evolving therapy approaches for primary BAD, with a focus on existing diagnostic limitations and unmet clinical needs. A thorough literature search was conducted using electronic databases such as PubMed, Scopus, Embase, and Google Scholar. BAD, bile acid malabsorption, IBS-D, FXR, FGF19, SeHCAT, serum C4, fecal bile acids, and bile acid sequestrants were all covered using both Medical Subject Headings (MeSH) and free-text phrases. A narrative synthesis was conducted on pertinent original research, reviews, clinical trials, and guidelines published in English. According to available data, a major mechanism underlying primary BAD is defective FXR-FGF19-mediated feedback inhibition. Nonspecific symptoms, overlap with functional gastrointestinal illnesses, and limited access to established diagnostic instruments, such as the SeHCAT retention scan, are the causes of persistent diagnostic difficulties. Alternative biomarkers, such as fecal bile acid measurement, FGF19, and blood 7α-hydroxy-4-cholesten-3-one (C4), show promise for diagnosis but are still unreliable and poorly standardized. The mainstay of treatment remains bile acid sequestrants, although there are no uniform management algorithms, and treatment response varies. Future therapy options may be enhanced by novel strategies targeting bile acid signaling pathways.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.