Anti-diarrhoea medicines such as codeine phosphate or loperamide (Imodium). Anti-diarrhoea drugs are usually much more effective if taken 30-60 minutes before main meals. They are most helpful in people with mild bile salt malabsorption. Taking a regular dose at the same time(s) every day seems to give the most benefit. However, most people find that they still get unpredictable episodes of diarrhoea even when taking the anti-diarrhoea drugs regularly. Anti-diarrhoea drugs are least likely to help those people with bile salt malabsorption that have frequent greasy, pale stools.
Bile acid sequestrants: These are a very specific treatment for bile acid malabsorption. Currently, there are two different types of bile acid sequestrant available in powder and tablet forms.
Powders: There are two similar types of powders, colestyramine (Questran) and colestipol (Colestid). These have been available for years. Very occasionally, a dose on alternate days is enough. Most people, however, need to take them regularly once, twice or even three times every day depending on the severity of their symptoms. About one in four people cannot take them because they cannot tolerate the taste or because the powders make diarrhoea worse or cause intolerable nausea, heartburn, wind or bloating.
Tablets: Colesevelam- dose can be between two and seven tablets a day in two or three doses, usually after food.
Colesevelam -is only licensed in the UK to treat high cholesterol. It does this by binding bile salts in the bowel. It can also be used for other reasons such as bile salt malabsorption but this does mean that if a patient in the UK developed some sort of serious problems as a result of taking this drug for bile salt malabsorption, it might limit the drug manufacturer’s liability. Also, most general practitioners in the UK are unlikely to be prepared to write out repeat prescriptions because it is not licensed for bile salt malabsorption,
Colesevelam can potentially cause the same side effects as the powders Though it tolerated much better and easier to take
Powders are normally the first medication to be tried.
If the patient can tolerate them, the powders are safe drugs. As the tablet is quite a new drug, we have less information about its long term safety. However, as it works in a similar way to the powders and is not absorbed from the bowel, it seems likely it will have a similar safety record to the powders. So far, there are no concerns at all about the long-term safety of the tablet.
All forms of bile acid sequestrants may lower cholesterol levels when taken for a long time. There are however, three possible problems with them:
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IMPORTANT INFORMATION ON BLOOD TESTING DUE TO COVID-19
If you are experiencing symptoms associated with COVID-19, e.g. fever, loss of taste or continuous new cough, please DO NOT attend for a blood test.
Earlier this year, the Government revised the guidance on Shielding for CEV patients. All those who have been identified as CEV have been advised to follow the same guidance as everyone else, whilst potentially thinking about extra precautions you could take to reduce your chance of catching COVID-19.
Taking into account this guidance, and the evidence that most patients have now resumed having their blood tests at their usual preferred location, UHCW will no longer be providing the Shielding phlebotomy service from Monday 13 December 2021. You will need to make arrangements to get your blood tests done, as you did prior to the pandemic at locations across Coventry and Warwickshire at www.uhcw.nhs.uk/bloodtests If your specialist has requested a blood test which is due to be taken prior to Monday 13th December, you can expect it to take place at a ‘Pop-up’ clinic, as before. Any blood tests required after this date will need to be a booked appointment.
You can keep up to date with the latest advice from the Government and from UHCW on the following website: www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
Click on the map for information about phlebotomy clinics in Coventry. You can book an appointment online at the locations in red.
Please book an appointment before attending for a blood test. Click on the ‘Book Online’ button above. Booking an appointment helps patients, their carers and family members to plan their hospital visit better, helping to reduce clinic waiting times and enabling patients to be seen much more quickly.
Location: Outpatients Department, on the ground floor. Opening hours: 8am-4.45pm, Monday to Friday (excluding bank holidays).
Children under 16 years old will need to book online here.
Please book an appointment before attending for a blood test, click on the ‘Book Online’ button above. Patients from Rugby and the surrounding areas are able to access the Friends Blood Taking Unit at the Hospital of St Cross.
Referrals for blood tests can be from GP's, practice nurses or from hospital consultants. Patients are also able to leave other samples, such as urine, which have been collected at home, at the hospital's Pathology Reception.
Location: Near Brookfield House, just off North Road - map here. Opening hours: The blood taking clinic sessions for adults and children are listed below:
Monday -Friday 7am-4:45pm Appointment only
Wednesday Evening 5pm-7pm Suspended due to COVID
Saturday Morning 7am-10pm Suspended due to COVID
April 2020 NEW - This Clinic is now by appointment. Please book an appointment before attending for a blood test. Click on the ‘Book Online’ button above.
Address: Stoney Stanton Road, Coventry CV1 4FS Location: Access is via the main doors, the Phlebotomy team are in Area A. Opening hours: Monday to Friday (excluding bank holidays). 8am–4.45pm
Glucose Tolerance Test (GTT)
Specialist Tests - There are a small number of specialist tests where blood needs to be taken on a hospital site as the sample must be transferred to the laboratory rapidly for the test to be undertaken. Click here for a list of these specialist tests and to find out more.