Table 3

Specific blood tests: responding to the results

Any malabsorptive syndromes, eg, Pancreatic insufficiency, BAM	▸ Check vitamin D, trace elements (selenium, copper and zinc) and INR (for vitamin K). ▸ If deficient: start appropriate supplementation and recheck levels in 3 months ▸ Request yearly monitoring via GP.
Short bowel syndrome	▸ Check vitamin D, trace elements (selenium, copper and zinc) and INR (for vitamin K). ▸ Spot urine sodium. ▸ If deficient: start appropriate supplementation and recheck levels in 3 months ▸ Request yearly monitoring via GP.
If bleeding	▸ Check full blood count and INR. ▸ Discuss immediately with supervising clinician and gastroenterologist/GI surgeon/haematologist.
When on a bile acid sequestrant	▸ Check triglyceride levels annually. ▸ Check vitamin D and INR (for vitamin K) annually. ▸ Check trace elements (selenium, zinc, copper) annually.
Cortisol level	▸ 09:00 am level needed. If low, arrange synacthen test. If abnormal, needs immediate discussion with endocrinologist.
Severe acute abdominal pain	▸ Amylase. If elevated this is an emergency.
Neuroendocrine tumour	▸ Urinary 5HIAA. ▸ Chromogranin A+B.

5HIAA, 5-hydroxyindole acetic acid; BAM, bile acid malabsorption; GI, gastrointestinal; GP, general practitioner; INR, international normalised ratio.