Treatment of Constipation with Chenodeoxycholic Acid

Abstract

The aim of this study was to investigate whether the cathartic effect of chenodeoxycholic acid (CDCA) could be helpful in the management of chronic constipation. Twenty cholesterol gall-stone patients with chronic constipation were randomly treated with either CDCA (750 mg/day in three divided doses at meals) or placebo for a period of 4 weeks. The administration of CDCA produced a significant increase of stool frequency and a decrease of stool consistency, while placebo was not effective in improving the bowel habit of the patients. As some patients complained of diarrhoea, and some had no modification of bowel frequency, further studies are needed to determine the most appropriate dose for each patient.

Effects of Chenodeoxycholate and a Bile Acid Sequestrant, Colesevelam, on Intestinal Transit and Bowel Function

“…Studies of effects of bile acids on colon motility are contradictory: Taylor et al did not observe stimulation with 5 and 15 mM CDCA in the sigmoid colon of IBS patients [30]; whereas, Bampton et al [8] noted propulsive contractions in the colon of healthy volunteers with rapid rectal delivery of 1 mM CDCA. Therefore, our detailed transit measurements clarified the dose of bile salt required to accelerate colonic transit and suggest that ileocolonic delivery of CDC may enhance its efficacy, relative to the effects on fecal parameters in patients with constipation observed by Bazzoli et al [31] with oral administration of CDC.…”

“…Conversely, 2.25g per day CDC may improve stool frequency and consistency in some, but not all, constipated patients [31]. Methacrylate-coated capsule delivery of CDC to the ileocolonic region is associated with demonstrable colonic transit effects in healthy participants.…”

Bile Acids: Chemistry, Pathochemistry, Biology, Pathobiology, and Therapeutics

“…The feeding of CDCA induces dose-related diarrhea [91], and CDCA administration can be used to treat constipation [92]. Bile acid malabsorption induces diarrhea that is treated effectively with bile acid sequestrants [57].…”

Modulating bile acid pathways and TGR5 receptors for treating liver and GI diseases

“…When used for gallstone dissolution and cholestatic liver disease, CDCA was associated with diarrhea and, in patients with chronic constipation, it increased stool frequency and loosened stool consistency compared with placebo (6). On the other hand, ursodeoxycholic acid (UDCA) did not cause diarrhea, consistent with studies of bile acids on epithelial functions in animal models and in vitro (7,8).…”