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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]
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.
Primary bile acid diarrhea (Type 2 bile acid "malabsorption") may be caused by an overproduction of bile acids. [ 5 ] [ 9 ] Several groups of workers have failed to show any defect in ileal bile acid absorption in these patients, and they have an enlarged bile acid pool, rather than the reduced pool expected with malabsorption. [ 10 ]
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.
Cholecystectomy is the surgical removal of the gallbladder.Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. [1] In 2011, cholecystectomy was the eighth most common operating room procedure performed in hospitals in the United States. [2]
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 ]
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This diarrhea is the major patient complaint and has characterized jejunoileal bypass in the minds of patient and physician alike since the procedure was introduced. [citation needed] Bile salts help to keep cholesterol in solution in the bile. Following JIB, the bile salt pool is decreased as a consequence of reduced absorption in the small ...