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Letter
New treatment for bile salt malabsorption
  1. J Puleston,
  2. H Morgan,
  3. J Andreyev
  1. Department of Medicine and Therapeutics, Imperial College Faculty of Medicine, Chelsea and Westminster Hospital, London, UK
  1. Correspondence to:
    Dr H J N Andreyev
    Department of Medicine and Therapeutics, Imperial College Faculty of Medicine, Chelsea and Westminster Hospital, 369 Fulham Rd, London SW10 9NH, UK; j.andreyevic.ac.uk

https://doi.org/10.1136/gut.2004.054486

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    Currently available binding resins used for symptomatic bile salt malabsorption are generally poorly tolerated because of unpalatability and associated gastrointestinal side effects. We suggest that there is now a viable alternative, colesevelam hydrochloride (WelChol, Sankyo Pharmaceuticals Inc., Japan).

    A 30 year old man presented with steatorrhoea, progressive weight loss, marked abdominal bloating, and lethargy after a right hemicolectomy following a road traffic accident in 1966.

    Physical examination, relevant blood tests, barium follow through, colonoscopy, and microscopic examination of colonic biopsies were normal. A trial of cholestyramine in preference to a SeCHAT scan caused cessation of diarrhoea on one sachet per day. However, his abdominal bloating continued unabated and he found the treatment unpalatable. Cholestyramine was therefore changed to colesevelam 2.5 g/3.75 g on alternate days. This was well tolerated, …

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    Footnotes

    • Conflict of interest: None declared.