Clinical Trials

Inclusion Criteria

• Prior diagnosis of IBS-D or functional diarrhea at Mayo Clinic will be specifically recruited and invited to participate
• Patients with prior measurements of 48h total fecal bile acids or serum C4 will NOT be excluded
• IBS symptoms positive by Rome III criteria 
• Functional Diarrhea
  • Loose (mushy) or watery stools without pain occurring in at least 75% of stools
  • Criterion fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis
• Age 18-65 years 
• Men or women
  • Ratio of 5 female to 1 male expected
  • Lactating women are eligible

Exclusion Criteria

• Women who are currently pregnant are not eligible to participate due to changes in hepatic metabolism or cholestasis that may occur during pregnancy 
• Use of drugs or agents within the past 1 week or planned use in the subsequent 10 days during the study period
  • Birth control pill, estrogen replacement therapy, metformin and thyroxine replacement are permissible exceptions
  • Agents that alter GI transit including opioids, narcotics, anticholinergics
  • Analgesic drugs including opiates and COX 2 inhibitors
  • Intake of medication that could interfere with the interpretation of the study
• Abdominal surgery (except appendectomy) specifically, prior gastric surgery, vagotomy, cholecystectomy and any small bowel resection will be excluded
• Known chronic liver disease or history of elevated AST/ALT 2.0 X ULN
• BA synthesis and possible false positive or negative fecal bile acid or serum 7alphaC4 result
  • If there are no AST or ALT values in the medical record, the study physicians will determine if the tests need to be run