This affects 1:100 people and symptoms include urgent diarrhoea – even in the middle of the night – which is often accompanied with pain, gas and bloating, fatigue, nausea, indigestion, weight gain and even depression. Sufferers are always scanning for the nearest toilet and it can take over their life, there is no cure and symptoms are managed with medication. Symptoms can be there for years, or even a decade, before there is a proper diagnosis as information on this condition is often thin on the ground.
What causes BAD?
Symptoms are caused by bile salts, which are made in the liver and stored in the gallbladder, not being recycled in the body properly. 95% of these bile salts should be recycled and reabsorbed and put back into the blood stream by the small intestine but this isn’t happening. Bile is essential for the breakdown of the fats and fat soluble vitamins.
BAD sufferers have an excess of bile salts entering the large intestine and the body responds by attracting more fluid into this area which then produces urgent watery stools. There are two types of BAD, primary and secondary. Primary is diagnosed when there are more bile salts than the small intestine can deal with and is considered hormonal. The secondary is when the small intestine has been damaged either by surgery, radiotherapy or by disease but this is then broken down into two categories. Type I is inflammation in the small intestine due to Crohns and Type II can occur due to various reasons i.e. with the removal of the gallbladder, it can happen after radiation or with SIBO (small intestinal bacteria overgrowth) and also be due to damage caused by coeliac disease or chronic pancreatitis. Diagnosis is done via stool and blood tests.
The UK support group for this condition is http://www.bamsupportuk.org/