{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:57:37Z","timestamp":1785891457601,"version":"3.56.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,2,10]],"date-time":"2019-02-10T00:00:00Z","timestamp":1549756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01\u2010DK115950"],"award-info":[{"award-number":["R01\u2010DK115950"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biomarkers in irritable bowel syndrome (<jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>) may guide targeted therapy in this multifactorial disease. It has been suggested that 75% accuracy and cost &lt;$500 categorise biomarkers as cost\u2010effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify differences in faecal bile acids, faecal fat and fasting serum C4 (7a\u2010hydroxy\u20104\u2010cholesten\u20103\u2010one) and fibroblast growth factor 19 (FGF19) among patients with IBS\u2010D, IBS\u2010C and healthy controls and to determine accurate, cost\u2010effective biomarkers for clinically relevant diarrhoea and constipation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We assessed daily stool frequency and consistency (Bristol Stool Form Scale) from validated bowel diaries, 48\u00a0hours total and individual faecal bile acids, 48\u00a0hours faecal fat and weight, fasting serum C4 and <jats:styled-content style=\"fixed-case\">FGF<\/jats:styled-content>19, and colonic transit by scintigraphy from healthy volunteers (<jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content>) and patients with <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010D and <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010C (Rome <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> criteria). We utilised multivariate logistic regression to determine biomarkers of clinically significant diarrhoea or constipation based on stool frequency, consistency and weight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 126 <jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content> (44M\/82F, 37.5\u00a0\u00b1\u00a010.9\u00a0years [<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>]), 64 <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010D (5M\/59F, 41.9\u00a0\u00b1\u00a012.2\u00a0years), and 30 <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010C (0M\/30F, 44.6\u00a0\u00b1\u00a010\u00a0years) patients, there were significant differences between all groups in stool weight, frequency, and consistency; in addition, there were differences in colonic transit at 48\u00a0hours, faecal fat, and total and individual faecal bile acids between <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010D and <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010C. Reduced total and primary faecal bile acids and increased faecal lithocholic acid were significant predictors of decreased faecal weight, frequency and consistency with <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>\u00a0&gt;\u00a00.82 (sensitivity &gt;76%, specificity &gt;72%). Total and primary faecal bile acids and faecal fat were significant predictors of increased stool weight, frequency and consistency with <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>\u00a0&gt;\u00a00.71 (sensitivity &gt;55%, specificity &gt;74%).The faecal parameters had a 11.5 positive likelihood ratio in predicting elevated faecal weight.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Faecal bile acids and faecal fat are cost\u2010effective and accurate biomarkers associated with significant bowel dysfunction among <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010D and <jats:styled-content style=\"fixed-case\">IBS<\/jats:styled-content>\u2010C patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15106","type":"journal-article","created":{"date-parts":[[2019,2,11]],"date-time":"2019-02-11T03:55:39Z","timestamp":1549857339000},"page":"744-758","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Bile and fat excretion are biomarkers of clinically significant diarrhoea and constipation in irritable bowel syndrome"],"prefix":"10.1111","volume":"49","author":[{"given":"Priya","family":"Vijayvargiya","sequence":"first","affiliation":[{"name":"Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.) 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