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Hi Jenny – there is something called bile acid malabsorption (BAM) that is sometimes seen with microscopic colitis and also celiac – one of the ways they test for this is whether the diarrhea resolves on cholestyramine. Since you had a definite response to the powder, this may be going on along with the sensitivities. You have been fully compliant with the first phase of the diet so we know it’s not that. I know you prefer not to take any medication, but the cholestyramine in conjunction with the anti-inflammatory diet may be the way to get best results for you at this stage. BAM if present and food sensitivities are two different things and have to be addressed separately as well. Does this make sense? I would resume the prescribed powder and when the diarrhea settles advance the anti-inflammatory diet to get your gut healthy. Let me know what you think – call if you want to chat.
What do you guys think, have you ever heard of this with celiac or LC?
bile acid malabsorption
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Jenny,
There are many discussions about bile acid malabsorption in the archives of this board - it comes up often. Virtually everyone with an inflammatory bowel disease, (and that includes us, and celiacs, as well), has bile acid malabsorption to some extent, because of inflammation in the terminal ileum, (where bile salts are normally reabsorbed and recycled. However, not everyone responds favorably to taking cholestyramine.
For some of us it can cause cramps, and other abdominal pain, and possibly other issues, (since for someone with intestinal inflammation, it can lead to a cholesterol insufficiency, and adequate cholesterol is necessary for proper digestion, and many other body processes. In some cases, it can cause constipation. Cholestyramine does nothing to suppress the inflammation that causes MC or any other IBD - it's simply a bile acid sequestrant.
The bottom line is, if it helps, use it, if it hurts, don't use it.
Tex
There are many discussions about bile acid malabsorption in the archives of this board - it comes up often. Virtually everyone with an inflammatory bowel disease, (and that includes us, and celiacs, as well), has bile acid malabsorption to some extent, because of inflammation in the terminal ileum, (where bile salts are normally reabsorbed and recycled. However, not everyone responds favorably to taking cholestyramine.
For some of us it can cause cramps, and other abdominal pain, and possibly other issues, (since for someone with intestinal inflammation, it can lead to a cholesterol insufficiency, and adequate cholesterol is necessary for proper digestion, and many other body processes. In some cases, it can cause constipation. Cholestyramine does nothing to suppress the inflammation that causes MC or any other IBD - it's simply a bile acid sequestrant.
The bottom line is, if it helps, use it, if it hurts, don't use it.
Tex
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.
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MaggieRedwings
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I took cholestyramine for a couple months and didn't notice improvement while taking it. My GI allowed me to try it but I was also taking prednisone at the same time so I really didn't know if it helped during that period of time. I continued with it after I stopped the prednisone and the horrible D wasn't even tolerable so I think I have my answer on that one. I also wanted to try it too because my son takes it (twice as much as I was prescribed) and has debilitating stomach pains and nausea. I wanted to see my reaction if nothing more than to know how he feels.