Cholestyramine questions

Discussions on the details of treatment programs using either diet, medications, or a combination of the two, can take place here.

Moderators: Rosie, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh

Post Reply
User avatar
Sue777
Gentoo Penguin
Gentoo Penguin
Posts: 448
Joined: Sun Jun 19, 2005 10:07 pm
Location: Connecticut

Cholestyramine questions

Post by Sue777 »

Hi Team.
I have a few questions (well, lots actually, but I'll try not to throw too many at you at one time) about cholestyramine. I did do a search and I have read all the posts and threads about it so I apologize in advance if I missed anything that's already been discussed.

I asked my doc for a script last Friday so I could try it and he agreed. He recommended 4 grams once a day but being cautious, I took 2 grams that night. Since the sky didn't fall, I took 2 grams Saturday afternoon and 2 more grams Saturday evening. And then last night I took 2 grams again (not sure why, wasn't thinking - should have taken 4).

1. Since this can interfere with absorption of other things, timing is tricky, so I think I'm going to always take it before bed. But I, of course, want to know how and why this stuff works (if it does) so I can understand if "before bed" really is the best time to take it. What is the half-life of this stuff? I read that it stays in your intestinal tract, but of course it can't stay there forever. Does it work at absorbing any acids that are there as soon as you take it, or does it take hours for it to start absorbing acid? Does it keep absorbing through the entire next day, or should I take two or three doses a day to keep a consistent level in my gut?

2. I might be doing a tad better this morning (diarrhea wise) but wow do I have bloating and gas pains. I read that's a common side effect but I wonder if that's something I should wait out in the hopes that gets better or if that's a sign that it's doing damage to my lining and I need to stop taking it? If I need to wait it out and let this side effect pass (pun intended) I'm fine with that, as long as I know I'm not making things worse.

3. Not sure where I read it (here or in Wayne's book) but it seems even people who do have success with cholestyramine don't have long term success. It works until it doesn't. Wondering why that is and/or hoping it's not true.

OK, that's enough for now, but you KNOW I'll be back with more. :)
Sue
Sue
Diagnosed November 2004, Used Asacol and Lialda, sometimes worked, sometimes made it worse. Entocort always works but hate it. Remission only lasts 3-6 months and then back on Entocort. Enterolab test July 2017, now gluten free. Time will tell!
User avatar
tex
Site Admin
Site Admin
Posts: 35070
Joined: Tue May 24, 2005 9:00 am
Location: Central Texas

Post by tex »

Sue,

I was hoping someone else would respond because I don't have any experience with this stuff, so I can't offer any advise on the bloating and gas. When "they" say it stays in your digestive tract they simply are trying to say that you won't absorb any of it. It will be purged right on schedule along with the rest of the stuff in there according to your motility. It's active and ready to go to work when you swallow it, and it will continue to bind things until you purge it according to your current turnaround time. IOW, it has to be replaced in roughly 24–30 hours or less, or whatever your normal turnaround time might be.

It shouldn't be able to do any damage to your epithelial lining because it's basically pretty inert stuff.

I hope it wasn't me who said that cholestyramine has a limited period of effectiveness. But then I might have pointed out that the human body is very adaptive and it can get used to almost anything. And along with that it learns to compensate, which means that in the long-term it may adapt to limit the effectiveness of some/many medications if it perceives it/them as adverse. But I really don't know if cholestyramine is one of them (or maybe I've forgotten). :shrug:

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
User avatar
Sue777
Gentoo Penguin
Gentoo Penguin
Posts: 448
Joined: Sun Jun 19, 2005 10:07 pm
Location: Connecticut

Post by Sue777 »

Thanks, Tex.
Your explanations and theories make sense, as they always do.

Yesterday was a horrible day.... I barely got to work because I couldn't get out of the bathroom and once I got there I was dashing to the ladies room constantly. When I went home to try to eat something, I had to put on protective undergarments to go back and for the first time, I actually brought a spare set of clothes with me to the office. I stayed about 30 minutes, threw in the towel, and took my laptop and went home. I'm working from home today, too, but am SO MUCH BETTER.

Why, you ask? could be one of two things: when I got home from the office yesterday I took two Entocort. It's the only thing that has ever worked to get me out of a flare. I also took an Immodium. AND... I skipped the cholestyramine last night.

I think the cholestyramine was producing the bloating and gas which is not a good thing when you have colitis (as you know). I can't believe the Entocort could have helped already, but something has. Of course I haven't eaten yet today, either, but will attempt that in a few minutes and see how long I can keep the food in my system.

Thanks for replying - I guess there aren't many cholestyramine users that are still active on this forum. Maybe that's a good thing for them - means it's working!
Sue
Sue
Diagnosed November 2004, Used Asacol and Lialda, sometimes worked, sometimes made it worse. Entocort always works but hate it. Remission only lasts 3-6 months and then back on Entocort. Enterolab test July 2017, now gluten free. Time will tell!
User avatar
Gabes-Apg
Emperor Penguin
Emperor Penguin
Posts: 8332
Joined: Mon Dec 21, 2009 3:12 pm
Location: Hunter Valley NSW Australia

Post by Gabes-Apg »

Sue
maybe doing a search for the previous discussions about cholestryamine and see what others have shared.

bloating and gas is not unusual during the healing stage. taking something like cholestryamine changes the digestion chemical structure big time. it is also a binder of toxins, (it is usesd by those with bacteria / fungal /mould issues) so it can also cause imbalance with good bacteria.

my observation of people here that have used cholestryamine, it is similar to other meds for MC;
- some have good long term success
- some get short term success that fades
- others can not tolerate it at all.

there is no way of knowing if it will work until you try it.
Gabes Ryan

"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
User avatar
Sue777
Gentoo Penguin
Gentoo Penguin
Posts: 448
Joined: Sun Jun 19, 2005 10:07 pm
Location: Connecticut

Post by Sue777 »

Thanks, Gabes. I did do a search and read all the threads I found before posting my questions. But you know me - I always want more. :)

Yes, as with most things, it's trial and error, won't know till you try, etc. We are all human guinea pigs in our quest to heal ourselves.

Thanks for the reply.
Sue
Sue
Diagnosed November 2004, Used Asacol and Lialda, sometimes worked, sometimes made it worse. Entocort always works but hate it. Remission only lasts 3-6 months and then back on Entocort. Enterolab test July 2017, now gluten free. Time will tell!
User avatar
Gabes-Apg
Emperor Penguin
Emperor Penguin
Posts: 8332
Joined: Mon Dec 21, 2009 3:12 pm
Location: Hunter Valley NSW Australia

Post by Gabes-Apg »

always want more
maybe that is part of your issue, wanting more, wanting improvements faster, overthinking, over researching,

maybe it is time to just be, let the bad days happen, give the body a bit of time, calm the mind a bit, be at peace with some of the messiness that is happening.
Gabes Ryan

"Anything that contradicts experience and logic should be abandoned"
Dalai Lama
User avatar
Erica P-G
Rockhopper Penguin
Rockhopper Penguin
Posts: 1815
Joined: Sun Mar 08, 2015 2:06 pm
Location: WA State

Post by Erica P-G »

HI Sue,

Gas and bloating.....one has to take the original version of Cholestyramine real sugar not the sugarless one....the sugarless one gave me worse gut symptoms.

Then on the real stuff, it took a good 21-28 days before my body got into a rhythm and the bile salts were absorbed properly etc....yes it took that long, if I was having other body issues it was because of stress, diet or a myriad of other things.

I took my cholestyramine 2 hours after I ate breakfast in the morning ....so I ate at 6:00 am and I took the cholest at 8:00 am just before I headed to work, I ate again at noon...then I would eat at a good time 6 ish at night and and take the cholest at 8 ish about an hour before bed so that I could go to the bathroom and not worry about waking in the middle of the night to pee.

In between the hours of 8 am and 8 pm I would take my magnesium and VitD at 6 am when I ate....then I would take my mag again at noon that is 4 hours after the cholest....that is the trick right there you have to give proper time after taking it so that it doesn't collect your supplements :-) then I would take my mag one more time at dinner time....at this point I had satisfied my supplement regimen :-)

If you haven't given yourself a good long stretch of time on the cholestyramine I don't feel it has had the time necessary to perform like it does. I was on it for a good 7-8 months after it started performing and I was able to get a good bit of healing under my belt that I no longer take it unless I get a flare that I can't seem to get under control. Then I know I need to be diligent once more with a good 15-21 days to get the healing to take effect once more and give the gut a rest. So far I've only had to do that once since January 2017. I'm doing so much better now days. I'm not perfect either, and there are days that norman just disappears for a brief 2-3 days and then comes back again, I don't run to the cholestyramine when those episodes happen, lol. But I would if I couldn't get a week situation under control at this point in my healing.

Good luck with the cholest....if it doesn't work after taking it for the alloted 21 days then perhaps your healing situation needs a bit more tweaking and time....the cholest comes into play after one has exhausted everything they have been taught to try and look into from this forum first....that is where I was, I plateaued and felt I was just at the turning point of healing....then the cholest helped me get the rest of the way.
To Succeed you have to Believe in something with such a passion that it becomes a Reality - Anita Roddick
Dx LC April 2012 had symptoms since Aug 2007
User avatar
Sue777
Gentoo Penguin
Gentoo Penguin
Posts: 448
Joined: Sun Jun 19, 2005 10:07 pm
Location: Connecticut

Post by Sue777 »

Thanks for the reminder, Gabes.... that's probably the best piece of non-medical device a person could receive. Actually it could be considered medical advice as well. When I was talking to my Higher Powers the other day asking "OK, guys... what lesson is it you're trying to teach me from this - what haven't I learned yet that you want me to?" The answer I got was that I don't need to have an answer to everything - some things I just need to "accept".

Erica, that's also good advice. Do you have a gallbladder? it almost seems cholestyramine is a wonder drug for those that don't but not so helpful for those who do. All I know is that Sunday and Monday were horrendous diarrhea days (even wore protective undergarments to the office yesterday and brought a spare set of clothes) so I gave my body a break and didn't take the cholestyramine last night. Today? I haven't gone at all. Amazing how much can change in 24 hours.

The quest continues....
Sue
Sue
Diagnosed November 2004, Used Asacol and Lialda, sometimes worked, sometimes made it worse. Entocort always works but hate it. Remission only lasts 3-6 months and then back on Entocort. Enterolab test July 2017, now gluten free. Time will tell!
User avatar
Erica P-G
Rockhopper Penguin
Rockhopper Penguin
Posts: 1815
Joined: Sun Mar 08, 2015 2:06 pm
Location: WA State

Post by Erica P-G »

HI Sue,
yes I have my gall bladder....an I have to place myself in the most healthy normal body situation pre MC....I don't suffer from any other autoimmune things...I still have my tonsils even. MC hit me out of the blue...but I think stress set it off and I think my body was working up to something because I have always been a picky eater and there were foods I would try to eat years before the MC came to fruition and I didn't like them or knew they weren't making me feel that great but couldn't put my finger on just what it was until now.

Every one is different.....and perhaps this just isn't the right timing for you to try this aspect of healing. That's ok :wink:

Until you find the food choices that are safe for you and you get to a stable place that feels good for a while only then will you know if you should even try cholestyramine....it will be evident because you keep passing yellow bile in your bathroom breaks and it may even give a bit of a burning sensation on the bum due to it...then it wouldn't hurt to try the cholest protocol. Until then carry on and get to a good place first.
To Succeed you have to Believe in something with such a passion that it becomes a Reality - Anita Roddick
Dx LC April 2012 had symptoms since Aug 2007
User avatar
Sue777
Gentoo Penguin
Gentoo Penguin
Posts: 448
Joined: Sun Jun 19, 2005 10:07 pm
Location: Connecticut

Post by Sue777 »

Erica P-G wrote:
Every one is different.....and perhaps this just isn't the right timing for you to try this aspect of healing. That's ok :wink:

Until you find the food choices that are safe for you and you get to a stable place that feels good for a while only then will you know if you should even try cholestyramine....it will be evident because you keep passing yellow bile in your bathroom breaks and it may even give a bit of a burning sensation on the bum due to it...then it wouldn't hurt to try the cholest protocol. Until then carry on and get to a good place first.
:bouqueofpinkroses:
Sue
Diagnosed November 2004, Used Asacol and Lialda, sometimes worked, sometimes made it worse. Entocort always works but hate it. Remission only lasts 3-6 months and then back on Entocort. Enterolab test July 2017, now gluten free. Time will tell!
Pebbledash
Gentoo Penguin
Gentoo Penguin
Posts: 260
Joined: Sun Aug 11, 2013 1:37 pm

Post by Pebbledash »

Hi all,

Thanks for this valuable thread. I'm taking cholestyramine since the Budesonide took a little long to kick-in (it has now, thankfully). It definitely seems to cause gas/bloating.

The problem is that I don't really know whether it is doing any good, nor how long I am meant to stay on it.

If anyone has any basic lore on cholestyramine, I would be grateful . . . like, is there a limit to how long I should take it?

Thanks
Paul
skp
Adélie Penguin
Adélie Penguin
Posts: 214
Joined: Thu Jan 12, 2017 11:51 am
Location: North Carolina

Post by skp »

Sue, I'm so glad to see this post as I was just ready to ask about Cholestyramine. After doing relatively well with my limited diet, having a good series of normals for awhile with a few set backs now and then, I am suddenly having dark brown, smelly stools with lots of gas and stomach rumbling. Both are fairly new for me. My stools began getting softer, wormy or muddy, a few weeks ago. This week the D I described, hit this week.

Nothing in my diet has changed. I remain gluten, dairy, soy and egg free with low fiber. However, I have been eating more protein, perhaps than usual, adding liverwurst which has lots of fat.

My gallbladder was removed when I was 21, something my mother experienced at age 28.

Tomorrow I meet with my GI doc who is a good guy but not 100% sold on diet but he listens to me and seems interested.

My thinking is that I may have Bile Acid Malabsorption. I read that 35% of MCers having it. I don't notice yellow in my stools, however. Erica, I appreciate your dosing schedule should I end up taking Cholestyraine. I really, really don't want to go back on budesonide which I did in the beginning and tapered off.

Any thoughts?

Thanks,
Susan
Post Reply

Return to “Discussions on Treatment Options Using Diet, and/or Medications”