Sample interview questions: How do you assess and manage patients with gastrointestinal disorders related to malabsorption of bile acids?
Sample answer:
Assessment:
- Medical History: Assess for symptoms suggestive of malabsorption due to bile acids (e.g., diarrhea, bloating, abdominal pain, weight loss).
- Physical Examination: Inspect skin and mucous membranes for signs of malnutrition (e.g., pallor, dry skin, hair loss). Auscultate for borborygmi and palpate for enlarged liver or spleen.
- Laboratory Tests:
- Serum bile acids: Elevated levels indicate impaired bile acid absorption.
- Liver function tests: Abnormal levels may suggest liver disease, which can affect bile production.
- Lipid profile: Elevated triglycerides and decreased HDL cholesterol may be present.
- Nutritional assessment: Measure body weight, BMI, and laboratory markers of nutritional deficiencies (e.g., albumin, prealbumin).
Management:
- Dietary Modification:
- Restrict intake of foods high in saturated fat, triglycerides, and cholesterol, which increase bile acid production.
- Increase consumption of soluble fiber, which binds to bile acids and promotes their excretion.
- Medication Therapy:
- Bile acid sequestrants (e.g., cholestyramine, colesevelam): These bind to bile acids in the intestines, preventing their reabsorption and improving absorption of fat-soluble vitamins.
- Ezetimibe: Inhibits c… Read full answer
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