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Bile salt diarrhea can also be a side-effect of gallbladder removal. [1] Bile acid sequestrants are the principal therapy for bile acid-induced diarrhea. [7] [1] Cholestyramine, colestipol and colesevelam have all been used. Doses may not need to be as high as those previously used for hyperlipidemia.
Colestyramine is also used in the control of other types of bile acid diarrhea. The primary, idiopathic form of bile acid diarrhea is a common cause of chronic functional diarrhea, often misdiagnosed as diarrhea-predominant irritable bowel syndrome (IBS-D), and most of these patients respond to colestyramine. [4]
Bile acid malabsorption (BAM), known also as bile acid diarrhea, is a cause of several gut-related problems, the main one being chronic diarrhea. It has also been called bile acid-induced diarrhea, cholerheic or choleretic enteropathy, bile salt diarrhea or bile salt malabsorption.
Colestipol (trade names Colestid, Cholestabyl) is a bile acid sequestrant used to lower blood cholesterol, specifically low-density lipoprotein (LDL). [1] [2] It is also used to reduce stool volume and frequency, and in the treatment of chronic diarrhea. [3]
Chronic diarrhea in postcholecystectomy syndrome is a type of bile acid diarrhea (type 3). [3] This can be treated with a bile acid sequestrant like cholestyramine, [3] colestipol [2] or colesevelam, [7] which may be better tolerated. [8]
Colesevelam hydrochloride, the active pharmaceutical ingredient in Welchol, is a non-absorbed, lipid-lowering polymer that binds bile acids in the intestine, impeding their reabsorption. As the bile acid pool becomes depleted, the hepatic enzyme, cholesterol 7-α-hydroxylase, is upregulated, which increases the conversion of cholesterol to bile ...
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However, it has little benefit in improving acute diarrhea in children. [116] Bile acid sequestrants such as cholestyramine can be effective in chronic diarrhea due to bile acid malabsorption. Therapeutic trials of these drugs are indicated in chronic diarrhea if bile acid malabsorption cannot be diagnosed with a specific test, such as SeHCAT ...
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