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habba syndrome
WHAT IS HABBA SYNDROME
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Habba Syndrome – What It Is, What It Isn’t
Habba Syndrome is an association between chronic diarrhea and a dysfunctional gallbladder. The gallbladder is the storehouse for bile, which is produced by the liver and released by the gallbladder into the small intestine to help break down food. However, in Habba Syndrome, the gallbladder is not functioning properly, causing diarrhea. It is not irritable bowel syndrome (IBS), a common and chronic disorder of the large intestine. The root cause of Habba Syndrome is the inappropriate amount of bile in the gastrointestinal tract, which can cause diarrhea and at times, incontinence.
Habba Syndrome diarrhea classically occurs after eating (post-prandial) and is rarely nocturnal unless the patient has eaten close to bedtime. It is not associated with internal bleeding, unless it comes from irritation of the rectal area, which would show up as bright red blood in or around the stool.
Dr. Saad Habba, a Summit, NJ-based gastroenterologist, has seen thousands of patients over the course of his medical career, and was the first to discern key differences between the “wastebasket” diagnosis of IBS and how patients with Habba Syndrome present.
Since 2000, a diagnosis of Habba Syndrome has helped countless people combat the debilitating effects of chronic diarrhea caused by an overproduction of bile by the gallbladder and begin to enjoy life once again without the worry and the limits of debilitating diarrhea.
Primary symptoms of Habba Syndrome
● Chronic diarrhea – three or more bowel movements (solid, watery, or explosive) a day for three or more months
● Post-prandial (after meals) diarrhea
● Fear of eating (to avoid symptoms)
● Dysfunctional gallbladder, determined by radiological testing
● Failure to respond to IBS therapy
● Favorable response to bile acid-binding agents
● Bathroom Mapping
Do you have Habba Syndrome?
Your physician may have diagnosed you with IBS because of your abdominal pain, bloating, and diarrhea. However, that diagnosis may be off target without the proper testing, leaving you frustrated, worried and living with life-altering, incapacitating symptoms that just don’t go away.
You may have fecal incontinence and wear adult diapers/incontinence pads to avoid embarrassing episodes. Perhaps you are avoiding social interactions or refuse to eat a meal because you’re afraid of what might happen. This also leads to unhealthy weight loss and social isolation.
A specialized gastroenterology workup and consultation with Dr. Habba can shed new light on your condition and bring symptom relief to chronic diarrhea.
Warning: Symptoms not associated with Habba Syndrome
The following symptoms are not typical of either IBS or Habba Syndrome. If you have these, you should alert your physician immediately:
- Rectal bleeding
- Anemia
- Unplanned weight loss
- Fever
- Family history of colon cancer
What are the primary symptoms of this syndrome?
- Post-prandrial diarrhea (varying from simple urgency to incontinence), associated with fear of eating to avoid diarrhea
- Dysfunctional gallbladder as determined by radiological testing
- Failure to respond to standard IBS therapy
- Favourable response to bile acid binding agents
What should you do if you have these symptoms?
Check with your primary care physician or gastroenterologist, who will examine you and determine if further diagnostic testing is necessary. Testing may include stool analysis, lab work, x-rays, and 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 look at gallbladder function by using a nuclear medicine x-ray study known as a DISIDA scan, with CCK injection to evaluate the ejection fraction of the gallbladder. This indicates if the gallbladder is working properly.
What is the treatment for Habba Syndrome?
Since the basic pathology of the syndrome is inappropriate bile in the gastrointestinal tract related to a dysfunctional gallbladder, therapy focuses on changing the constitution of bile acids to decrease their diarrheal effect. Agents that bind bile acids are proven as safe, effective, and inexpensive. Some are available in generic forms.
Patients should take these agents half an hour prior to meals to maximize the effect of binding to the bile acids. In the original publication describing this syndrome, patients treated with cholestyramine (Questran®) responded very favourably, usually within days of starting therapy.
How many people suffer from this Syndrome?
Most likely millions of people diagnosed with either “IBS” or spastic colon have Habba Syndrome. It is estimated that approximately 45 million American suffer from “IBS” or similar conditions. According to Dr. Habba’s study, 41% of patients had Habba Syndrome. If you are concerned about your condition, contact us to learn more about gastroenterology in Summit, NJ.
Most people accept chronic diarrhea as a “normal” form of life and learn to live with it and its limitations, socially or otherwise. Hence, the problem is much bigger than what we can appreciate.