A new article published in Frontiers in Pharmacology discussed that bile acid synthesis, excretion, and reuptake are tightly regulated. The apical sodium-dependent bile acid transporter [ASBT; also known as ileal bile acid transporter (IBAT) and SLC10A2] is crucial for the near complete reabsorption of conjugated bile acids in the ileum. While dysfunctional IBAT may be the cause of bile acid diarrhea. The authors described that pharmacological IBAT inhibition results in an increased bile acid load in the colon and subsequently, a lower bile acid pool which is associated with improved liver histology in cholestatic liver disease and non-alcoholic steatohepatitis (NASH). The article reported that in humans, IBAT inhibitors have been tested in clinical trials with widely different indications. In patients with idiopathic chronic constipation, an increased number of bowel movements was observed; in adult and pediatric cholestatic liver diseases with pruritus, various IBAT inhibitors showed potential to improve itching. Adverse events of IBAT inhibitors, based on their mode of action include abdominal pain and diarrhea.