Bile Acid Malabsorption
BAM Is a Mechanics Issue, Not a Microbiome Issue (At First) BAM happens when your bile acids aren’t reabsorbed in the small intestine like they should be — so they “spill over” into the colon, where they irritate the bowel and cause diarrhea or fat malabsorption. This has nothing to do with bacterial balance in your colon at first — but over time, excess bile acids can damage or alter the gut lining and affect microbes too. In my case, because I've eaten plant-based for years: Likely supported a diverse gut microbiome Had no issues until recently... It’s very likely my microbiome is still in good shape. The issue may lie in: How bile is being handled or recycled A change in digestion or absorption ability (e.g. hormone shifts, thyroid, age-related enzyme/bile output) You Can Have Both: A healthy microbiome And digestive dysfunction (like BAM, SIBO, or mild pancreatic insufficiency) What You Can Do: 1. Temporarily modify meals to reduce fat and fiber load just enough to ease digest...