Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what plans he has to help improve (a) clinical understanding, (b) diagnosis, and (c) treatment pathways for people with bile acid malabsorption.

The United Kingdom has a well-developed network of clinicians interested in bile acid disorders, namely the UK Bile Acid Related Diarrhoea Network, which is working with the National Institute of Health and Care Research (NIHR) on a major clinical trial.

The current treatment is mainly with “bile acid sequestrants” that bind the bile acids in the gut, but there is a recognised need to further develop new treatments. In 2025, the NIHR announced a £2 million investment in a research study to investigate the clinical and cost-effectiveness of treatments for bile acid malabsorption (BAM). Further information is available at the following link:

https://fundingawards.nihr.ac.uk/award/NIHR160696

In addition, BAM has been highlighted in national guidance on managing chronic diarrhoea by the British Society of Gastroenterology, and the National Institute for Health and Care Excellence (NICE) has issued public-facing guidance on their website, which is available at the following link:

https://www.nice.org.uk/advice/esuom22/ifp/chapter/What-is-bile-acid-malabsorption

The standard diagnostic test for BAM is a SeHCAT study, pronounced “see cat” and named after the tauroselcholc [75 selenium] acid used in the procedure, and its use in the United Kingdom has rapidly expanded over the last 10 to 15 years, although there are limited research findings internationally, and consequently NICE has recently recommended further research in this area.