The pathophysiology of bile acid diarrhoea: differences in the colonic microbiome, metabolome and bile acids

Sagar, N. M. et al. (2020) The pathophysiology of bile acid diarrhoea: differences in the colonic microbiome, metabolome and bile acids. Scientific Reports, 10, 20436. (doi: 10.1038/s41598-020-77374-7) (PMID:33235223) (PMCID:PMC7686486)

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Abstract

Bile acid diarrhoea (BAD) is a common disorder resulting from increased loss of bile acids (BAs), overlapping irritable bowel syndrome with diarrhoea (IBS-D). The gut microbiota metabolises primary BAs to secondary BAs, with differing impacts on metabolism and homeostasis. The aim of this study was to profile the microbiome, metabolic products and bile acids in BAD. Patients with BAD diagnosed by SeHCAT testing, were compared with other IBS-D patients, and healthy controls. Faecal 16S ribosomal RNA gene analysis was undertaken. Faecal short chain fatty acid (SCFA) and urinary volatile organic compounds (VOCs) were measured. BAs were quantified in serum and faeces. Faecal bacterial diversity was significantly reduced in patients with BAD. Several taxa were enriched compared to IBS-D. SCFA amounts differed in BAD, controls and IBS-D, with significantly more propionate in BAD. Separation of VOC profiles was evident, but the greatest discrimination was between IBS-D and controls. Unconjugated and primary BA in serum and faeces were significantly higher in BAD. The faecal percentage primary BA was inversely related to SeHCAT. BAD produces dysbiosis, with metabolite differences, including VOC, SCFA and primary BAs when compared to IBS-D. These findings provide new mechanistic insights into the pathophysiology of BAD.

Item Type:Articles
Additional Information:Funding was from UHCW Trust’s charity as well as the Midlands Gastroenterology Society and Bardhan Research and Education Trust (BRET).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gerasimidis, Professor Konstantinos and Svolos, Dr Vaios
Authors: Sagar, N. M., Duboc, H., Kay, G. L., Alam, M. T., Wicaksono, A. N., Covington, J. A., Quince, C., Kokkorou, M., Svolos, V., Palmieri, L. J., Gerasimidis, K., Walters, J. R.F., and Arasaradnam, R. P.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Scientific Reports
Publisher:Nature Research
ISSN:2045-2322
ISSN (Online):2045-2322
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Scientific Reports 10: 20436
Publisher Policy:Reproduced under a Creative Commons License

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