Specific blood tests are indicated depending on the symptoms/diagnosis as outlined in the algorithm:
fat-soluble vitamins, trace elements, fasting gut hormones, INR, haematinics
Any malabsorptive syndromes, eg,
  • ▸ BAM

  • ▸ Pancreatic insufficiency

  • ▸ Short bowel syndrome

  • ▸ Check vitamins A–D–E, trace elements (selenium, copper and zinc) and INR.

  • ▸ If deficient: start appropriate supplementation.

  • ▸ Request yearly monitoring via GP.

If bleeding
  • ▸ Check full blood count and INR.

  • ▸ Discuss immediately with supervising clinician and gastroenterologist/GI surgeon.

When on a bile acid sequestrant
  • ▸ Check triglyceride levels annually.

  • ▸ Check fat-soluble vitamins A–D–E and INR (for vitamin K) annually.

  • ▸ Check trace elements (selenium, zinc and copper) annually.

Cortisol level
  • ▸ Morning level needed. If low, arrange synacthen test. If abnormal needs immediate discussion with endocrinologist.

  • BAM, bile acid malabsorption; GI, gastrointestinal; GP, general practitioner; INR, International Normalised Ratio.