Bile Acid Malabsorption — RACP Adult Medicine MCQ
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Correct answer: A — Start a bile-acid sequestrant and titrate it around symptoms, interactions and tolerability
The best answer is “Start a bile-acid sequestrant and titrate it around symptoms, interactions and tolerability”. Very low SeHCAT retention supports bile-acid diarrhoea, and a bile-acid sequestrant such as colestyramine or colesevelam targets the mechanism. Dosing must account for constipation and binding of other medicines. Pancreatic insufficiency and coeliac disease are not supported; symptomatic antidiarrhoeal therapy may be adjunctive but does not address the demonstrated cause.
Reference: Gastroenterological Society of Australia: Clinical practice resources: https://gesa.org.au/Web/Resources/Clinical_Practice_Resources.aspx