Post Cholycystectomy Diarrhea

http://www.medhelp.org/perl6/gastro/archive/1868.html
Subject: Post Cholycystectomy Diarrhea
Topic Area: Gallbladders
Forum: The Gastroenterology and Liver Diseases Forum
Question Posted By: Chris on Wednesday, July 29, 1998



I had a lap-choly approx 18 months ago and have been plagued with
"regular" diarrhea. Immediately after eating lunch, my intestine
spasms very uncomfortably, forcing me to find a restroom quick. I
finally went to my doctor who prescribed Questran.
Is there anything else on the market besides Questran? Will I
need this protocol forever?

Does a fat free diet really help?



Dear Chris,

Postcholycystectomy diarrhea is felt to be caused by bile acids being dumped into the colon. These bile acids stimulate water secretion causing diarrhea. It would seem logical that the most appropriate class of medication that would be helpful to control this type of diarrhea, would be a bile acid resin binder. Cholestyramine (Questran, Prevalite) is usually helpful in this regard but can have a gritty taste and cause nausea, abdominal bloating and constipation. It can also interfere with the absorption of a variety of medications and vitamins over the long term. You should be aware that there is a powder form of Questran called Questran light (for oral suspension) which is supposed to be better tolerated. Another bile acid resin binder is colestipol (Colestid). Colestipol is available as granules, flavored granules or tablets and is also only available by prescription. The granules can be mixed with breakfast cereals and juices for better compliance. These medications are usually required for prolonged periods, but if you obtain significant relief, you can titrate the medication to the lowest dose needed to control your symptoms. If you do not receive any benefit from the bile acid resin binding agents you may want to try anti-diarrheal agents such as Immodium or Lomotil to see if they are effective (after consulting your primary physician).

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