Drugs for bile salt malabsorption

The longest established drug for bile salt malabsorption is cholestyramine. Lie oll of the drugs widely used for this indication it works by binding to bile salts within the gut and preventing their osotic effect on the flow of salt and water within the large bowel (colon). Cholestyramine is sold under a number of names but commonly appears as “questran” or “questran light” within the UK. Cholestyramine is generally cheap and widely available however there are occasional supply problems and many patients find it very unpalatable. The commonest side-effect is just not being able to face swallowing it, but nausea may also arise. Sometimes mixing it with cordial may help make it easier to swallow.

Cholestagel, sometimes sold as colesevelam  is a much more expensive alternative which many patients find more palatable and more effective.