Managing Bile Acid Malabsorption

Introduction

Bile acid malabsorption (BAM) is a condition characterized by the impaired absorption of bile acids in the small intestine. This can lead to digestive symptoms such as diarrhoea, abdominal pain, bloating, excess gas and in some malnutrition. While medication is often prescribed to manage BAM, adopting a suitable diet and lifestyle can also play a significant role in alleviating symptoms and promoting a healthy gut. In this blog post, we will explore some practical tips to help manage bile acid malabsorption and improve your overall well-being.

Who is at risk of BAM?

• Anyone who has had surgery to their small bowel or an anterior resection (large bowel surgery)

• Stoma reversals

• Gallbladder operation

• Inflammation in the small bowel (for example in Crohn’s disease)

• Genetic cause (sometimes people with IBS-D are misdiagnosed)

• Radiotherapy to the pelvic area (abdomen)

• Small intestinal bacterial overgrowth (SIBO), Coeliac disease and pancreatitis

IMPORTANT NOTE = If you are underweight or already have a restrictive diet it is important not to over restrict and seek support from a dietitian if you can.

Understand Your Triggers

Identifying and understanding your food triggers is crucial in managing BAM. Keep a food diary to track your symptoms and determine which foods worsen your condition. Common triggers may include high-fat foods & caffeine containing foods/drinks. By reducing these triggers from your diet, you can reduce symptoms and enhance your quality of life.

Lady on the floor filling out her food symptoms diary

Embrace a Lower-Fat Diet:

Consuming a lower-fat diet can be beneficial for individuals with bile acid malabsorption. High-fat foods can increase the production of bile acids, exacerbating symptoms. Opt for lean proteins like poultry, fish, and tofu, and choose low-fat dairy products.

A jar of low fat yoghurt and granola which is good for gut health
A nutritious plate of grilled tuna steak and vegetables

above are Examples of lower fat options

Fibre-Friendly Choices

While increasing fibre intake is generally recommended for a healthy gut, those with BAM may need to approach it with caution. Soluble fibres (found in oats, bananas, carrots, and chia seeds) are generally better tolerated than insoluble fibres (found in bran, and pitch and skins) for individuals with BAM. Experiment with different fibre sources and monitor how your body responds. If you have been restricting fibre due to diarrhoea and want to increase it do it slowly. Gradually increase fibre intake to avoid potential digestive discomfort.
bowl of porridge with low fat yoghurt and berries

Smaller, Frequent Meals:

Instead of consuming large meals, try eating smaller, more frequent meals throughout the day. This can help regulate bile acid production and prevent overwhelming your digestive system. Space out your meals to allow for proper digestion and absorption of nutrients, reducing the likelihood of triggering symptoms. Chew your foods well and eat slowly.

Hydration is Key:

Staying adequately hydrated is essential for maintaining optimal gut health. Drinking enough water helps regulate bowel movements and prevents dehydration, which can worsen diarrhoea. Aim to drink at least eight glasses of water per day and limit your intake of dehydrating beverages like coffee and alcohol.
mug of mint tea

Stress Management:

Chronic stress can exacerbate digestive symptoms for individuals with BAM. Incorporate stress management techniques into your daily routine, such as meditation, deep breathing exercises, yoga, or engaging in hobbies you enjoy. Prioritizing self-care can significantly reduce stress levels and promote a healthier gut.

Seek Professional Guidance:

Managing bile acid malabsorption can be complex, and it’s always wise to consult with a registered dietitian experienced in gastrointestinal disorders. They can provide personalized guidance, develop a tailored diet plan, and help you navigate through any challenges you may face

Conclusion:

Although bile acid malabsorption can be challenging to manage, adopting the right diet and lifestyle modifications can make a significant difference in controlling symptoms and improving your overall well-being. By understanding your triggers, making dietary adjustments, practicing stress management techniques, and seeking professional guidance, you can take control of your gut health and live a more comfortable, fulfilling life. Remember, everyone’s body is unique, so be patient with yourself, listen to your body, and make choices that work best for you.

For more support if you have or suspect you have BAM contact Gina
Gina has expertise managing this condition via diet, lifestyle and medication (if needed)

ginag@therehabdietitian.com