Bile acid dysmetabolism and microbial dysbiosis coincide with Clostridioides difficile infection in pediatric inflammatory bowel disease

Pediatric inflammatory bowel disease (IBD) patients are at increased risk for Clostridioides difficile infection. This review highlights bile acid dysmetabolism, driven by gut microbiota dysbiosis and reduced microbial production of secondary bile acids, as a key factor linking pediatric IBD to increased CDI susceptibility. We examine interactions among IBD, dysbiosis, bile acid metabolism, and C. difficile , and discuss emerging microbiome-based interventions aimed at restoring bile acid homeostasis.