An opportunity for integrative approaches: an examination of the perspectives of women with Bile acid malabsorption (BAM)

IF 1.7 Q2 Medicine Advances in integrative medicine Pub Date : 2022-05-01 DOI:10.1016/j.aimed.2022.04.002
David Sarchet , Justine Bold
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Abstract

Background

The aim was to explore experiences of individuals with the controversial conditions bile acid diarrhoea (BAD) and bile acid malabsorption (BAM). BAD/BAM are poorly understood, misdiagnosis is common and there is evidence that around a third of patients with Irritable Bowel Syndrome (diarrhoea) (IBS-D) may have BAD/BAM.

Methods

In depth, semi-structured interviews were undertaken with six participants, all female, 18 + years old and living in the UK. All had been diagnosed with BAD/BAM for at least one year. Interviews were recorded and transcribed verbatim. Data was coded and thematic analysis was undertaken using grounded theory.

Results

Six main themes emerged including 1. triggers, and how to control symptoms; 2. experience of diagnosis/care and associated delays; 3. psychosocial impact of the condition, this specifically identified impacts on mental health; 4. the signs and symptoms; 5. comorbidities and other health problems and finally 6. self-education/learning for management of BAD/BAM. Findings indicate that BAD and BAM are often poorly understood; and patients experience delays with diagnosis and moreover that the condition has profound effects on the lives of patients including impacting on mental health. A low-fat diet was identified as useful in managing symptoms, however participants had concerns over absorption of fat-soluble vitamins such as vitamin D and often experienced fatigue.

Conclusion

Further research is recommended to understand both the psychosocial and nutritional impacts of BAD/BAM and to understand the management strategies of patients and the potential role of integrative medicine in caring for this group.

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综合方法的机会:对胆汁酸吸收不良(BAM)妇女的观点的检查
目的是探讨个人的经验与有争议的条件胆汁酸腹泻(BAD)和胆汁酸吸收不良(BAM)。人们对BAD/BAM知之甚少,误诊很常见,有证据表明,大约三分之一的肠易激综合征(腹泻)(IBS-D)患者可能患有BAD/BAM。方法对6名18岁以上居住在英国的女性进行深度半结构化访谈。所有患者被诊断为BAD/BAM至少一年。采访被逐字记录和抄写。对数据进行编码,并利用有根据的理论进行专题分析。结果出现了6个主要主题,包括1;诱因,以及如何控制症状;2. 诊断/护理经验和相关延误;3.心理社会影响,这特别确定了对心理健康的影响;4. 体征和症状;5. 合并症和其他健康问题最后6。自我教育/学习管理BAD/BAM。研究结果表明,人们对BAD和BAM往往知之甚少;患者会延迟诊断,而且这种情况对患者的生活有深远的影响,包括影响心理健康。低脂饮食被认为对控制症状有用,但参与者担心吸收脂溶性维生素(如维生素D),并经常感到疲劳。结论建议进一步研究BAD/BAM的社会心理和营养影响,了解患者的管理策略以及中西医结合在护理这一群体中的潜在作用。
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来源期刊
Advances in integrative medicine
Advances in integrative medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
3.20
自引率
11.80%
发文量
0
审稿时长
15 weeks
期刊介绍: Advances in Integrative Medicine (AIMED) is an international peer-reviewed, evidence-based research and review journal that is multi-disciplinary within the fields of Integrative and Complementary Medicine. The journal focuses on rigorous quantitative and qualitative research including systematic reviews, clinical trials and surveys, whilst also welcoming medical hypotheses and clinically-relevant articles and case studies disclosing practical learning tools for the consulting practitioner. By promoting research and practice excellence in the field, and cross collaboration between relevant practitioner groups and associations, the journal aims to advance the practice of IM, identify areas for future research, and improve patient health outcomes. International networking is encouraged through clinical innovation, the establishment of best practice and by providing opportunities for cooperation between organisations and communities.
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