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Introduction Bile acid diarrhoea (BAD) is a common cause of chronic diarrhoea estimated to have a population prevalence of 1%. Principal treatment is with bile acid sequestrants.Patients with BAD often have symptoms for years prior to diagnosis, experiencing symptoms of increased stool frequency, diarrhoea and faecal incontinence.Recent epidemiological studies highlight patients with BAD have additional comorbidities and inferior socio-economic parameters compared to the general population.This study aimed to explore lifestyles of patients with BAD in a semi-structured interview studyMethods 12 patients with BAD underwent a 30–45-minute semi-structured recorded interview using a video conference software. Lead author was present as a moderator for all interviews to ensure consistency.Interviews followed a semi-structured design with questions included symptoms and experiences prior to diagnosis, current treatments and effect on lifestyle. The main author was present for all interviews to ensure consistency.Thematic analysis was performed on transcribed interview data. Otter.ai software was used to summarise interviews to aid in establishing themes.Results Patients with primary/idiopathic BAD often had a delayed diagnosis of several years, with several doctor visits and more than one gastroenterology referral before diagnosis. This contrasted with patients with secondary BAD (post radiotherapy or terminal ileum resection) who were diagnosed promptly on developing symptoms.Patients prior to diagnosis often tried to hide their symptoms from friends and family and avoided social events and public transport. Urgency and risk of incontinence was frequently reported as the most severe symptom.Activities that were avoided included those with limited access to toilets with public transport causing significant anxiety. Patients described preparation for limited toilet access including a period of fasting, taking spare clothes and taking prophylactic loperamide.Post diagnosis, participants still experienced some breakthrough symptoms and were hesitant to engage in activities with limited toilet access, even if symptoms were now well controlled. Some participants stated working from home was a great aid to living with their condition.Discussion The study highlights the significant decreased quality of life experienced by patients with BAD. It further highlights delay in diagnosis, an unmet treatment need, and types of activities that patients avoid affecting both work and social activities.The interview results will be used to create a new symptom questionnaire to further explore the prevalence and severity of these symptoms in a larger patient cohort.