A bile acid sequestrant currently indicated for the treatment of type 2 diabetes and primary hyperlipidemia could also help Crohn’s disease (CD) patients with bile acid malabsorption (BAM)-associated diarrhea. In the randomized, double-blind, placebo-controlled multicenter study of 34 CD patients ages 18–65 years, patients received either colesevelam or identically shaped placebo for four weeks. Patients taking colesevelam had a significant reduction in the number of liquid stools by the end of the study, while the placebo group had no statistically significant reduction. The primary endpoint of >30% reduction of liquid stools/day from baseline to end of study was met in nearly 70% of colesevelam patients vs. 27.3% in the placebo group. Colesevelam may be a suitable alternative treatment option for CD patients with BAM-associated diarrhea who are intolerant or do not respond to cholestyramine or other bile acid sequestrants, but larger studies are needed for further examination.
Bile acid malabsorption (BAM)-associated diarrhea is an important clinical issue in patients with Crohn’s disease (CD).