Bile acid malabsorption (BAM) is a condition in which the body cannot properly absorb bile acids, critical molecules that aid digestion and absorption of fats and fat-soluble vitamins from food. When these bile acids aren't properly absorbed, they can irritate the lining of the intestines and lead to gastrointestinal symptoms such as diarrhea, abdominal pain, bloating, and flatulence.
While medication is often used to treat BAM, some natural remedies may also be effective. This article will explore some of the most well-researched natural remedies for this condition.
Causes of BAM
BAM can be caused by various factors, including medical conditions like inflammatory bowel disease, ileal resection, chronic diarrhea, or idiopathic causes. Excess bile acids in the colon can also contribute to bile acid diarrhea (BAD), which is often confused with BAM but is a separate condition.
Symptoms of BAM
The most common symptoms of BAM include watery and loose diarrhea, abdominal pain, bloating, and flatulence. Diarrhea associated with BAM is often pale, smelly, and difficult to flush due to the excess bile acids in the body. Other symptoms of BAM may include fecal incontinence, excessive gas, and stomach pain. These symptoms can significantly impact a person's quality of life and may require medical attention.
Natural Remedies for Bile Acid Malabsorption
Several natural remedies have been researched for their effectiveness in managing bile acid malabsorption (BAM). While medication is often used to treat this condition, natural remedies may help manage symptoms and improve quality of life. This section will explore some of the most well-researched natural remedies for BAM, including dietary changes, probiotics, psyllium, turmeric, calcium supplements, vitamin B12, vitamin D, chia seeds, and aloe vera.
Diet Changes
One of the most effective natural remedies for bile acid malabsorption is dietary changes. Some foods can exacerbate symptoms of BAM, while others can help to alleviate them. People with this condition must work with a healthcare professional to determine which foods are best for them. 1 However, some general dietary tips include:
- Eat smaller, more frequent meals throughout the day.
- Avoid foods high in fat, as these can trigger symptoms.
- Eat foods high in soluble fiber, such as oatmeal, apples, and beans.
- Avoid caffeine, alcohol, and carbonated beverages.
- Drink plenty of water to stay hydrated.
Probiotics
Probiotics are live microorganisms that are found in some foods and supplements. They are often called "good bacteria" because they help promote a healthy balance of bacteria in the gut. Some evidence suggests that probiotics may be beneficial for people with bile acid malabsorption. 2
One study found that a probiotic supplement containing Lactobacillus acidophilus and Bifidobacterium lactis improved symptoms of diarrhea in people with this condition. 3
Another study found that a probiotic supplement containing Lactobacillus reuteri reduced symptoms of abdominal pain and bloating. 4
Psyllium
Psyllium is a type of soluble fiber that is often used as a laxative. It is derived from the husks of Plantago ovata seeds and is available in supplement form. Some evidence suggests that psyllium may benefit people with bile acid malabsorption.
One study found that psyllium supplementation improved symptoms of diarrhea in people with this condition 5 Another study found that psyllium supplementation increased the amount of bile acids that were excreted in the feces, suggesting that it may help to bind to excess bile acids in the gut.6
Turmeric
Turmeric is a spice that is commonly used in Indian cuisine. It contains a compound called curcumin, which has anti-inflammatory and antioxidant properties. There is evidence to suggest that turmeric may be beneficial for people with bile acid malabsorption.
One study found that curcumin supplementation reduced symptoms of diarrhea and abdominal pain in people with this condition.7
Another study found that curcumin supplementation improved markers of inflammation in the gut.8
Calcium Supplements
Calcium supplements have been shown to reduce the amount of bile acids in the colon, which may help to alleviate symptoms of BAM. One study found that calcium supplementation reduced diarrhea frequency and improved the quality of life in people with this condition.9 It is recommended to take calcium supplements with meals to optimize absorption.
Vitamin B12
Vitamin B12 is important for producing red blood cells and the health of the nervous system. Chronic diarrhea caused by BAM can lead to deficiencies of this essential vitamin. Vitamin B12 supplements may be recommended for people with BAM to help correct deficiencies and alleviate symptoms. 10
Vitamin D
Vitamin D is important for bone health and immune function. People with BAM may be at risk for vitamin D deficiency, as the absorption of fat-soluble vitamins can be compromised. Vitamin D supplements may be recommended to prevent deficiencies and support overall health. 11
Chia Seeds
Chia seeds are a good source of soluble fiber, which can help to regulate bowel movements and alleviate symptoms of BAM. One study found that chia seed supplementation improved symptoms of diarrhea in people with this condition. 12 Chia seeds can be easily added to smoothies, oatmeal, or yogurt for a nutritional boost.
Aloe Vera
Aloe vera has anti-inflammatory and soothing properties that may help to alleviate symptoms of diarrhea and abdominal pain in people with BAM. One study found that aloe vera gel reduced symptoms of diarrhea in people with ulcerative colitis, a condition that can be associated with BAM. Aloe vera can be consumed in juice or supplement form. 13
Summary
Bile acid malabsorption can cause a range of uncomfortable symptoms, including diarrhea, abdominal pain, and bloating. While medication is often used to treat this condition, some natural remedies are effective. People with bile acid malabsorption may find by making dietary changes, taking probiotics, and supplementing with psyllium, turmeric, calcium, vitamin B12, vitamin D, chia seeds, and aloe vera relief from their symptoms.
Do you have a natural remedy suggestion for BAM? Please send us your feedback! Continuer reading below for feedback from Earth Clinic readers.
Citations
- Fernandez-Bañares F, Esteve M, Salas A, Forné TM, Espinos JC, Martín-Comin J, Viver JM. Bile acid malabsorption in microscopic colitis and in previously unexplained functional chronic diarrhea. Dig Dis Sci. 2001 Oct;46(10):2231-8. doi: 10.1023/a:1011927302076. PMID: 11680602.
- Sivamaruthi BS, Fern LA, Rashidah Pg Hj Ismail DSN, Chaiyasut C. The influence of probiotics on bile acids in diseases and aging. Biomed Pharmacother. 2020 Aug;128:110310. doi: 10.1016/j.biopha.2020.110310. Epub 2020 Jun 3. PMID: 32504921.
- Li L, Liu T, Gu Y, Wang X, Xie R, Sun Y, Wang B, Cao H. Regulation of gut microbiota-bile acids axis by probiotics in inflammatory bowel disease. Front Immunol. 2022 Sep 23;13:974305. doi: 10.3389/fimmu.2022.974305. PMID: 36211363; PMCID: PMC9539765.
- Saviano A, Brigida M, Migneco A, Gunawardena G, Zanza C, Candelli M, Franceschi F, Ojetti V. Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin? Medicina (Kaunas). 2021 Jun 23;57(7):643. doi: 10.3390/medicina57070643. PMID: 34201542; PMCID: PMC8306447.
- Psyllium: Eswaran, S., Muir, J., & Chey, W. D. (2013). Fiber and functional gastrointestinal disorders. The American Journal of Gastroenterology, 108(5), 718-727. https://doi.org/10.1038/ajg.2013.63
- Buhman KK, Furumoto EJ, Donkin SS, Story JA. Dietary psyllium increases fecal bile acid excretion, total steroid excretion and bile acid biosynthesis in rats. J Nutr. 1998 Jul;128(7):1199-203. doi: 10.1093/jn/128.7.1199. PMID: 9649606.
- Hanai, H., Iida, T., Takeuchi, K., Watanabe, F., & Maruyama, Y. (2006). Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial. Clinical Gastroenterology and Hepatology, 4(12), 1502-1506. https://doi.org/10.1016/j.cgh.2006.08.008
- Burge K, Gunasekaran A, Eckert J, Chaaban H. Curcumin and Intestinal Inflammatory Diseases: Molecular Mechanisms of Protection. Int J Mol Sci. 2019 Apr 18;20(8):1912. doi: 10.3390/ijms20081912. PMID: 31003422; PMCID: PMC6514688.
- Lupton JR, Steinbach G, Chang WC, O'Brien BC, Wiese S, Stoltzfus CL, Glober GA, Wargovich MJ, McPherson RS, Winn RJ. Calcium supplementation modifies the relative amounts of bile acids in bile and affects key aspects of human colon physiology. J Nutr. 1996 May;126(5):1421-8. doi: 10.1093/jn/126.5.1421. PMID: 8618139.
- Caspary WF, Zavada I, Reimold W, Deuticke U, Emrich D, Willms B. Alteration of bile acid metabolism and vitamin-B12-absorption in diabetics on biguanides. Diabetologia. 1977 May;13(3):187-93. doi: 10.1007/BF01219698. PMID: 873086.
- Maislos M, Shany S. Bile salt deficiency and the absorption of vitamin D metabolites. In vivo study in the rat. Isr J Med Sci. 1987 Nov;23(11):1114-7. PMID: 2830204.
- Tamargo A, Martin D, Navarro Del Hierro J, Moreno-Arribas MV, Muñoz LA. Intake of soluble fibre from chia seed reduces bioaccessibility of lipids, cholesterol and glucose in the dynamic gastrointestinal model simgi®. Food Res Int. 2020 Nov;137:109364. doi: 10.1016/j.foodres.2020.109364. Epub 2020 Jun 4. PMID: 33233067.
- Langmead L, Feakins RM, Goldthorpe S, Holt H, Tsironi E, De Silva A, Jewell DP, Rampton DS. Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis. Aliment Pharmacol Ther. 2004 Apr 1;19(7):739-47. doi: 10.1111/j.1365-2036.2004.01902.x. PMID: 15043514.
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