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Unlocking a New Understanding of IBS-D: The Role of INSL5 in Chronic Diarrhea

A mysterious gut hormone may be behind many cases of chronic diarrhea, especially in people with undiagnosed bile acid malabsorption, a condition often mistaken for irritable bowel syndrome. Researchers from the University of Cambridge identified that the hormone INSL5 spikes when bile acid reaches the colon, triggering intense diarrhea. Their discovery not only sheds light on the biological cause of symptoms but opens the door to a diagnostic blood test and new treatment options, including a surprising existing drug that blocks this hormone’s effects.

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4 seconds ago

July 30, 2025

Charlotte A

The study published in the journal Gut has shed light on the potential link between high levels of the gut hormone INSL5 and up to 40% of cases of irritable bowel syndrome with diarrhea (IBS-D). Researchers at the University of Cambridge have been exploring whether this hormone plays a role in chronic diarrhea, which can be triggered by bile acid malabsorption. This is a significant breakthrough, as it may lead to the development of a blood test for diagnosing IBS-D and provide new insights into potential treatments.

Bile acid diarrhea (also known as bile acid malabsorption) affects around one person in every 100, causing urgent and watery diarrhea. The condition can be difficult to diagnose, with many individuals receiving a diagnosis of irritable bowel syndrome (IBS), an umbrella term for various conditions. Studies have suggested that INSL5 may play a role in chronic diarrhea, particularly in cases triggered by bile acid malabsorption.

Researchers at the University of Cambridge collaborated with pharmaceutical company Eli Lilly to develop a new antibody test that allows them to measure tiny amounts of INSL5. They analyzed samples from patients with IBS-D and found that levels of INSL5 were significantly higher in those with bile acid diarrhea, compared to healthy volunteers.

The study’s findings also provide potential targets for treatment. Dr. Chris Bannon, the first author of the study, notes that understanding the role of gut hormones like INSL5 is essential for developing effective treatments for IBS-D and other gastrointestinal disorders.

The research was supported by the Medical Research Council and Wellcome, with additional support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre. The study’s findings have significant implications for the diagnosis and treatment of IBS-D, a condition that affects millions worldwide.

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