Which condition results from excess bile acids entering the colon, often after cholecystectomy?

• A. Bile acid diarrhea due to increased colonic bile acids.
• B. Irritable bowel syndrome with diarrhea.
• C. Crohn disease affecting the colon.
• D. Lactose intolerance.

Answer: (A)

Excess bile acids reaching the colon can drive secretory, watery diarrhea. After cholecystectomy, the gallbladder is removed, so bile is delivered to the intestine more continuously rather than pooled and released in a controlled, meal-induced fashion. That increased and unbuffered flow brings more bile acids into the colon, where they stimulate secretion and accelerate transit, producing bile acid diarrhea.

This is specifically bile acid diarrhea (bile acid malabsorption) caused by colonic exposure to bile acids. Other options describe different processes: IBS with diarrhea is a functional bowel habit change not typically linked to excess bile acids; Crohn disease would involve inflammatory changes in the colon; lactose intolerance arises from lactase deficiency causing osmotic diarrhea with lactose ingestion.