Calm, evidence-based help

Living with microscopic colitis and bile acid malabsorption.

Finally — clear, human answers to the thing that's been running your days. What both conditions really are, why so many of us have both, and the practical steps that actually help when nothing else has.

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~44%
of MC patients have BAM on SeHCAT testing
an estimated 40%
of those whose diarrhoea doesn’t settle with diet
Scroll to meet Reg — he's been where you are and will walk you through it
Reg, the friendly MLC & Me guide

It starts here

Five trips a day, and every test says you're fine.

You plan your life around the nearest bathroom. You've been scanned, scoped and told everything looks 'normal' — until someone finally looks under a microscope.

  • Microscopic colitis
  • Invisible illness

Finally, a name

Microscopic colitis hides where eyes can't see.

The truth was under a microscope all along — inflamed colon cells a standard scope can walk straight past. A name, at last, for what your body's been telling you.

  • Lymphocytic colitis
  • Collagenous colitis
  • Colonoscopy + biopsy

Why it won't stop

The missing piece most doctors never test for.

Around 44% of people with MC were found to have bile acid malabsorption on SeHCAT testing. When bile acids spill into the colon they act like poison — a hidden engine behind the diarrhoea that diet alone can't quiet.

  • Bile acid malabsorption
  • SeHCAT scan
  • ≈40% when diet isn't enough

One plan

Two conditions. One turning mechanism.

Living with both isn't double the trouble — it's a different balance entirely. Bile binders, fat timing and your MC care have to move together, like one machine.

  • Sequestrants
  • Lower-fat timing
  • Med spacing

Free guide

A path out of the fog, a page at a time.

No fear-mongering, no miracle cures. A calm, evidence-based walkthrough for flare days, food, and the questions worth asking your GI team.

  • Flare-day guide
  • Symptom tracker
  • GI questions
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You were never alone

This is where the fog lifts for good.

Join others walking the same road. Weekly calm guidance, new research made clear, and deep-dive resources when you're ready to go further.

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The journey continues

That world above is your road — from fog, to a name, to a way forward.

Every step on that path — the confusion, the microscope, the hidden bile-acid piece, and the community waiting at the end — is a step others have already walked. Below is the plain-language version: what each condition is, and how to live well when both are part of your story.

Plain-language answers

Understanding both — not just one or the other.

Microscopic colitis

An invisible inflammation of the colon. Your gut looks normal on the outside, so it's easy for it to be missed — but under a microscope the inflammation is real, and it's driving the chronic, watery, urgent diarrhoea that's taken over your days. It's not 'all in your head' — it never was.

Bile acid malabsorption

The bile your liver makes to digest fat should be recycled in the small intestine. When it isn't — often because the ileum is inflamed — it overflows into the colon and acts like a laxative the body never asked for. The result is explosive, watery urgency that diet tweaks alone can't settle.

Why "you have both" changes the answers

Treat only one condition and the other keeps the cycle going. The relief comes when both are addressed together — the right diagnosis, a binder where it's needed, timed away from other medicines, and food choices that keep the bile load low and predictable.

Coming soon

Deeper resources for the road ahead.

When you're ready to go beyond the guide, detailed structured resources are on the way — complete flare-day playbooks, food and binder timing frameworks, and step-by-step MC + BAM management guides built from real lived experience.

The Complete BAM & MC Handbook

A practical guide to bile acid malabsorption when you also have microscopic colitis.

£12.99Coming soon
Get the free BAM fact sheet while you wait
Hear first when it launches Get updates on YouTube
Reg welcoming you to future resources
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Real answers to the questions you're typing

Microscopic colitis and BAM, in plain language.

+What is microscopic colitis?
Microscopic colitis is an inflammatory bowel condition that causes chronic, watery, non-bloody diarrhoea — often with urgency, night-time trips, cramps and weight loss. It's called 'microscopic' because the colon looks normal during a colonoscopy; the inflammation is only visible when a tissue biopsy is examined under a microscope. It has two main forms: lymphocytic colitis and collagenous colitis.
+What is bile acid malabsorption (BAM)?
Bile acid malabsorption — sometimes called bile acid diarrhoea — happens when bile acids, which are made by the liver to digest fat, aren't re-absorbed properly at the end of the small intestine (the terminal ileum). Instead they spill into the colon, where they act as an irritant and trigger urgent, watery diarrhoea. In many people with microscopic colitis the ileum is inflamed, so BAM is a very common companion.
+Can microscopic colitis and bile acid malabsorption happen together?
Yes — and for many people they do. Research using SeHCAT testing has found bile acid malabsorption in around 44% of people with microscopic colitis, and an estimated 40% of those whose diarrhoea doesn't settle with diet may have it as a major driver of their symptoms. That's why results can seem disappointing if only one of the two is being treated.
+Why is BAM so often missed?
BAM is genuinely under-diagnosed. In the UK a SeHCAT scan can detect it, but access varies and in many countries diagnosis comes down to a therapeutic trial: a bile acid binder (a sequestrant) is prescribed, and if symptoms improve you probably had it. Many people are only ever told they have 'IBS', so the bile-acid piece is never looked for.
+Does microscopic colitis cause weight loss?
Yes, it can. Persistent watery diarrhoea, food fear and reduced absorption during flares can lead to gradual, unintentional weight loss. Tracking weight and talking to your GI team early matters — significant or rapid weight loss always needs a proper review to rule out other causes.
+What actually helps, day to day?
There's no single fix, but a pattern shows up again and again: work with your GI team on diagnosis (and ask about BAM), consider bile acid sequestrants where appropriate, space them away from other medicines (they can block absorption), keep fat intake steadier (less fat = less bile reaching the colon), and track symptoms so patterns become visible. Calm consistency usually beats a dozen drastic changes at once.

Nothing here replaces your doctor. It's honest, lived-experience guidance to read alongside your care team — so you walk into appointments knowing the right questions to ask.