Bile Acid Dysregulation: Pathophysiology and Therapeutic Approaches to Bile Acid Diarrhea.

Bile acid dysregulation is an emerging yet underrecognized contributor to diarrhea in companion animals. This review explores the pathophysiology of bile acid malabsorption and its clinical manifestation as bile acid diarrhea, emphasizing its relevance in veterinary practice. Mechanisms include defects in bile acid regulation, ileal dysfunction, and dysbiosis-driven alterations in bile acid metabolism. Clinical signs often mimic chronic enteropathy, complicating diagnosis. Current veterinary diagnostics are limited, making therapeutic response to bile acid sequestrants a practical diagnostic and treatment approach. Evidence-based strategies, including dietary management and bile acid sequestrant therapy, are discussed to guide clinicians in managing this challenging condition.