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Most likely, millions of people diagnosed with either IBS or spastic colon have Habba Syndrome. It is estimated that approximately 45 million Americans suffer from those conditions. According to Dr. Habba’s study , 41% of patients that were diagnosed with IBS-D by their physicians actually had Habba Syndrome. If you are concerned about your condition, contact us to learn more about testing and treatment options at our gastroenterology practice in Summit, NJ. [jump link to chart section on IBIS or HABBA page]
Most people accept chronic diarrhea as a fact of life and learn to live with it and its limitations, socially and otherwise. But, like an iceberg, the problem is actually much deeper due to an underlying medical condition.
As identified by Dr. Habba, these are the primary symptoms of Habba Syndrome:
● Diarrhea after eating, which could range from simple urgency to incontinence
● Softer, watery stools (no evidence of blood on the stool)
● Lack of response to IBS standard treatments
These symptoms require medical consultation with a primary care physician or gastroenterologist. Patients can make an appointment with Dr. Habba for consultation and further diagnostic testing at his Summit, NJ gastroenterologist office.
Dr. Habba’s diagnostic testing will reveal if there is:
● Over-release of bile into the small intestine due to gallbladder dysfunction
● Positive response to bile acid-binding agents
Check with your primary doctor or gastroenterologist specialist in Summit, NJ.
A basic work up of the symptoms needs to be done such as stool analysis, lab work, x-rays and colonoscopy. Further testing to rule out malabsorptive conditions (celiac sprue, etc.), inflammatory bowel disease (ulcerative colitis and Crohn’s disease) and cancer need to be done before the syndrome diagnosis can be confirmed.
These tests must be done to rule out all other treatable conditions before starting therapy for Habba Syndrome.
The basic pathology of Habba Syndrome is inappropriate bile in the gastrointestinal tract related to a dysfunctional gallbladder. The gallbladder is a reservoir for bile, which is produced in your liver and flows from there into your gallbladder. In a healthy person, bile is held there until needed for food digestion. The gallbladder releases bile into the bile duct when you eat; it is then carried to the upper part of the small intestine to help break down fat in food.
Testing may include stool analysis, lab work, X-rays or nuclear medicine scans, and a colonoscopy. Further testing to rule out malabsorptive conditions, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), and cancer may be required.
To confirm a diagnosis of Habba Syndrome, doctors often look at gallbladder function by using a DISIDA scan—an exam of the gallbladder and the hepatobiliary system (the ducts connecting it to the liver and the small bowel) with CCK injection (CCK stands for cholecystokinin, a hormone that causes your gallbladder to empty and release bile). This enables gastroenterologists like Dr. Habba to evaluate the ejection fraction of the gallbladder to see if the gallbladder is working properly.
Therapy for Habba Syndrome changes the constitution of bile acids to decrease their diarrheal effect. Medications that bind bile acids have been used for many years and are proven safe, effective, and inexpensive. Some are available in generic forms.
Dr. Habba prescribes these bile acid-binding agents to be used one-half hour prior to meals for optimal effectiveness. In the original publication of the syndrome, cholestyramine (Questran®) was used with excellent response. However, similar results can be obtained with other agents such as colestipol (brand name Colestid) and colesevelam (Welchol). Dosage can be increased or tapered as symptoms stabilize.
Symptoms should improve within only a few days of continuous therapy. One may have to stay on the medication for a long time to achieve optimal health.
How long do I have to stay on medication?
As long as necessary to control diarrhea. Sometimes the frequency can be decreased with time depending on the response.
Is gallbladder surgery an accepted mode of therapy for Habba Syndrome?
Cholecystectomy (removal of the gallbladder) should not influence the outcome of the symptoms. In fact, approximately 10% of patients have similar symptoms after gallbladder removal. Hence, surgical removal of the gallbladder to treat chronic diarrhea is not appropriate for Habba Syndrome.
Does the medication have serious side effects if one takes it for a prolonged period?
Bile binding medicines have been out and used for many years. They are very safe. They do, however, interfere with absorption of Vitamin A,D,E, and K. So supplements and vitamin levels will have to be checked periodically. Also, these drugs may interfere with the efficacy and absorption of other medications so it is best to space them out from other medicines to avoid this issue.
Thank you for your interest. We look forward to hearing from you soon.
Saad F. Habba, MD
12 Bank Street, Suite 102, Summit, NJ 07901-3661
Phone: (908) 273-3434
Fax: (908) 273-3210
12 Bank Street, Suite 102
Summit, NJ 07901-3661
Phone: (908) 273-3434
Fax: (908) 273-3210
Saad F. Habba, MD
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