Bile Acid Malabsorption: Why “Unexplained” Diarrhea Keeps Returning

D2 • Feb 28, 2026 • 9 min read

An overview of bile acid malabsorption as an under-recognized driver of chronic diarrhea and urgency.

Quick answer

Bile acid malabsorption (BAM) is an under-recognized cause of chronic loose stools and urgency, especially in people labeled IBS-D.

Typical BAM pattern

  • Frequent loose stools and urgency.
  • Partial response to generic IBS interventions.
  • Recurring symptoms despite microbiome-focused protocols.

Bottom line: when bile handling is the problem, BAM-aware management can change outcomes quickly.