Poop with bile acid malabsorption is most commonly yellow or orange.
Understanding Bile Acid Malabsorption and Stool Color
Bile acid malabsorption (BAM) is a digestive disorder where bile acids, which are produced by the liver to aid in fat digestion and absorption, are not properly reabsorbed in the small intestine. Instead, they pass into the large intestine (colon) in excessive amounts.
The characteristic yellow or orange color of stool in BAM often results from:
- Rapid Transit: The presence of excess bile acids in the colon can irritate its lining, leading to increased bowel motility and rapid transit of stool. When stool moves too quickly through the digestive system, bile pigments, which normally give stool its brown color as they are processed, don't have enough time to undergo the complete breakdown and transformation.
- Unabsorbed Bile Acids: The unabsorbed bile acids themselves, or bile that hasn't been fully modified, can contribute to the yellow or orange hue. It is known that issues affecting bile salts, for instance, those that lower or eliminate bile salts in the body—such as certain liver disorders like cirrhosis or hepatitis—can also result in yellow stools, highlighting how disruptions in bile processing impact stool color.
Common Symptoms Associated with Bile Acid Malabsorption
Beyond the change in stool color, bile acid malabsorption often presents with a range of digestive symptoms due to the irritating effect of bile acids on the colon. These symptoms can vary in severity but frequently include:
- Chronic, Watery Diarrhea: This is the hallmark symptom, often described as urgent and frequent.
- Abdominal Pain and Cramping: Discomfort in the abdomen is common.
- Bloating and Gas: Excessive gas and a feeling of fullness.
- Fecal Incontinence: In some cases, the urgency of diarrhea can lead to accidental bowel leakage.
- Fatigue: Resulting from the chronic digestive upset and potential nutrient malabsorption.
- Weight Loss: If malabsorption of fats and nutrients is severe.
When to Seek Medical Advice
If you experience persistent yellow or orange stools, especially when accompanied by chronic diarrhea, abdominal pain, or unexplained weight loss, it is important to consult a healthcare professional. A doctor can properly diagnose bile acid malabsorption through various tests, such as a SeHCAT test or a therapeutic trial with bile acid sequestrants, and recommend appropriate management strategies.
