The investigators propose to develop studies of obeticholic acid (OCA) in patients with bile
acid diarrhoea. OCA is a semisynthetic bile acid, also known as 6αethylchenodeoxycholic acid
or INT747,and is a potent farnesoid X receptor (FXR) agonist. Preliminary data suggests that
patients with bile acid diarrhoea have impaired production of the ileal hormone Fibroblast
Growth Factor 19 (FGF19). FGF19 is stimulated by FXR agonists, and regulates bile acid
synthesis. This study is a pilot, proof-of-concept, open-label study to investigate whether
OCA can stimulate FGF19 in bile acid diarrhoea patients to provide a safe and effective
treatment.