Bile Salt Malabsorbtion

[Bradders]

I have been diagnosed with bile salt malabsorbtion. Had tests for celiac, endoscopy showed flattened villi but biopsy said not.
celiac.

Gp seemed rather dismissive of the final diagnosis and doesn't seen to know a lot about it or the medication I am on (Questran light). Please can you tell me a little mire, will it heal event?

[Dr Helen Webberley]

Hi there, if you have had any bowel or gall bladder surgery then this can upset the bile salt absorption. However, some people just suffer with it.

Questran is the right treatment, some people suffer all their lives, and some people get better.

If your biopsies are normal then you don't have coeliac.

I hope this helps.

Some more technical help can be found in this article:

http://www.uhcw.nhs.uk/bam/what-is-bam

Dr Webberley

[Dr Nick Read]

Bile acid malabsorption is very common in IBS-D (diarrhoea predominant IBS). It is most likely related to a rapid small bowel transit which dumps excessive amounts of bile acid into the colon. This irritates the colon causing secretion and peristalsis resulting in urgency and diarrhoea. Questran is certainly the right treatment but you have to be in charge of the dosing. I usually advise people to start with 1 sachet 20-30 minutes before every small meal and two sachets before the main meal of the day, but be prepared to increase or reduce the ose according to the response. If you begin to get constipated then reduce the dosage to half a sachet and one sachet. Rapid small bowel transit and IBS-D is often caused by stress so as the situation eases, you may find this is less of a problem and you can stop the questran. See http://www.theibsnetwork.org/the-self-c ... medicines/.