What Foods Excerbate Bile Salt Diarrhea?


Asked by Simone

I Am Looking For Information On The Foods That Might Excerbate Bile Salt Diarrhea

I was diagnosed years ago as having Irritable Bowel Syndrome. No matter the treatment, what foods I eliminated, it continued to get worse. My current gastroentronologist has now diagnosed bile salt diarrhea because I am responding well to Welchol (I still have my gall bladder). I am looking for information on the foods that might excerbate it. For example, I'm not sure why the word "salt" is in the title - might salt make it worse?

I've been searching the internet and have found mostly information on drugs that treat it.

I was surprised that on both Health Central and the Mayo Clinic website I could not find any information at all.

Thank you for any information or references you can provide.


Hello, Simone.

You have posted to our inflammatory bowel disease (IBD) site, dedicated to information and issues related to the autoimmune diseases, Crohn's disease and ulcerative colitis. (This is not intended as a general GI disorders informational site.)

However, I can tell you that the actual name for the disorder that you seem to have, is known medically as "bile acid malabsorption." (The symptom of chronic, watery, diarrhea is then often described as bile salt diarrhea.) In one study of sixty-two patients with chronic, watery diarrhea, it was considered to be the cause of diarrhea in twenty-eight (45.2%) patients.

You would do best to eat five or more small meals a day, consisting mostly of low fat and high protein foods, and complex carbohydrates(for instance, bread, pasta, rice, potatoes, and low-sugar cereals). Concentrated sugars and fats (such as fried foods, full fat dairy products, and fatty meats) should be kept to a minimum or avoided. Fluids should be reserved for between meals. Fiber supplements, along with antidiarrheal medications, can be used as needed to prolong intestinal transit time. Multivitamins with minerals should be taken orally two or three times a day.

Bile "salts" are actually bile "acids." Bile acids are steroid acids found in the bile of mammals. The two major bile acids are cholic acid, and chenodeoxycholic acid.

Bile acid diarrhea most often occurs in a diseased small intestine, at the point of the terminal ileum, or after surgical resection of the terminal ileum. There is increased exposure of the mucosa of the colon to bile salts, resulting in increased activation of fluid and electrolyte secretion.

Diagnosis primarily involves excluding more common causes of chronic diarrhea, and a diagnostic trial of bile acid-binding resins; you have reported that is exactly what your doctor has done.

Good luck.


You should know: The answer above provides general health information that is not intended to replace medical advice or treatment recommendations from a qualified healthcare professional.