Excessive fecal bile acid (BA) loss causes symptoms in a large proportion of people diagnosed with irritable bowel syndrome with diarrhea, a common functional bowel disorder. This BA diarrhea (BAD) results from increased hepatic synthesis of BAs, with impaired negative feedback regulation by the ileal hormone fibroblast growth factor 19 (FGF19). In this issue of the JCI, Zhao et al. investigated BA metabolism, including fecal BAs, serum BAs, and FGF19, in patients and controls. They identified associations between fecal bacterial BA metabolism and specific microbiota, especially Clostridium scindens. These findings have been tested in a mouse model using microbiota transplants and antibiotic treatment. This group of organisms has potential as a biomarker for BAD and to be a target for therapy.

中文翻译：

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慢性腹泻，胆汁酸和梭状芽胞杆菌。

粪便胆汁酸（BA）过多流失会在大多数诊断为肠易激综合症的人中引起症状，而腹泻是一种常见的功能性肠病。这种BA腹泻（BAD）是由于BA的肝脏合成增加，以及回肠激素成纤维细胞生长因子19（FGF19）引起的负反馈调节受损所致。在本期JCI中，Zhao等人。研究了患者和对照中的BA代谢，包括粪便BA，血清BA和FGF19。他们确定了粪便细菌BA代谢与特定微生物群（尤其是梭状梭状芽胞杆菌）之间的关联。这些发现已在使用微生物群移植和抗生素治疗的小鼠模型中进行了测试。这组生物体具有作为BAD的生物标记物和成为治疗靶标的潜力。