New treatment for bile salt malabsorption: Table 1

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, …