A new study conducted by researchers from AIIMS and other leading centers led by Dr. Govind K. Makhariya, has been published in the Indian Journal of Gastroenterology. The study finds that measuring bile acids in a single stool sample could provide a practical way to diagnose bile acid malabsorption (BAM) – a condition that is often missed because existing tests are complex and not widely available.Chronic diarrhea is often attributed to conditions such as irritable bowel syndrome, but experts say a significant number of these patients may actually have BAM, which requires a different line of treatment.“Chronic diarrhea is quite common in India, affecting about 8-10% of people, and about 80% of these cases are due to functional bowel disorders such as IBS. However, a small but significant subgroup of patients may have bile acid malabsorption, which often goes undiagnosed because existing tests are complex and not widely available. With new spot stool tests, it is now possible to identify these cases more easily and treat them accordingly,” Dr. Makhariya of the Department of Gastroenterology and Human said. Nutrition, AIIMS.The study tested a method that estimates fecal bile acids (FBA) using a simple assay and identifies a clear clinical cut-off. An FBA level of 2.8 μg/g was found to accurately detect the condition with high sensitivity (89.5%) and specificity (92%), indicating strong diagnostic performance.Researchers compared healthy individuals and patients suffering from intestinal diseases, finding that those affected had significantly higher levels of bile acids. When this was applied to real-world patient groups, the results were surprising.BAM was found in approximately 21% of patients with IBS-related diarrhea or functional diarrhea. The proportion was even higher in other groups – 57% in people who had gallbladder removal and more than 54% in patients with intestinal tuberculosis.These findings suggest that a large number of patients currently treated for other causes of chronic diarrhea may have an underlying, treatable condition that is being overlooked.Doctors say that this has a direct impact on care. Without correct diagnosis, patients often continue to suffer from symptoms despite treatment, leading to frequent consultations and reduced quality of life.The biggest advantage of the new approach is its simplicity. Unlike existing diagnostic methods, which are technically demanding and limited to specialized centres, this test can be performed on a single stool sample, making it far more accessible for routine use.Experts believe widespread adoption of such testing could help identify hidden cases earlier and enable more targeted treatment.