Bile Acid Malabsorption as a Driver of Epithelial Barrier Dysfunction in Crohn’s Disease

Crohn’s disease (CD) is a lifelong intestinal inflammatory disease, with a rapidly increasing prevalence. A common but often overlooked complication of CD is chronic diarrhea, which is frequently caused by a condition called bile acid malabsorption (BAM), affecting nearly half of CD patients. BAM-associated diarrhea greatly reduces quality of life, limits daily activities, increases healthcare costs, and is associated with a higher risk of gastrointestinal cancers. Unfortunately, current treatments often fail to relieve symptoms. This, in part reflects the uncertainty regarding where and how excess bile acids, chemicals that build up in BAM, damage the cells lining the intestine. This project will use human intestinal tissue-derived models, to examine how intestinal cells and bacteria respond to bile acids buildup in the intestine, identify mechanisms of injury, and test strategies to repair the gut lining. Findings will be shared through scientific publications, conferences, and collaborations with clinicians, patient organizations, and industry partners. This research aims to define how BAs damage the intestine during BAM, as well as guide better treatments, and ultimately improve quality of life for people living with CD.