To everyone who has diarrhoea-predominant IBS please read this…

About 3 months ago my GP prescribed me a trial run of cholestyramine as she’d been looking into bile acid disorder (BAD) as one of the causes of IBS-D (which I'd had for 3 years) and this medication seemed to be very successful in treating it. I can’t tell you how glad I am that I gave it a go!

Results were almost instant – no more diarrhoea (1 bm per day only), no more pain, nausea, gas or bloating and the freedom to eat whatever I like – high FODMAPs included.

It’s taken me this long to put this post up on here as I’ve been trying out all the foods I was previously unable to eat just to be sure of what I was saying but, as I’m pretty certain I’ve now got through them all, it’s time to pass on the info.

It's taken me a while to get the dose right as it’s very much an individual thing and I still fiddle around with it depending on what I'm going to eat and when.

I recently came across an article on the web about BAD and, very interestingly, the following quote from the IBS Network’s Dr Nick Read was included in it:

‘I diagnose bile acid malabsorption quite frequently in people with IBS and I find that cholestyramine is a very effective treatment. I’ve seen patients who have had diarrhoea for years dramatically improve using this treatment. Unfortunately, the impact of bile acid malabsorption in IBS is not well recognised. I would estimate that fewer than 20 per cent of gastroenterologists treat it.’

The only time I have any problems is if I don’t measure the dose properly and overdo it, I then get a bit of wind and bloating - and that serves me right for not taking care!

I hope this helps somebody else out there.


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11 Replies

  • Hey Roz that's fantastic news! Funnily enough I put a link up here a few months back about bile acid and diarrohea. It seems to be getting more widely known about. Also good to hear your GP is on the ball too:-)

  • Does colestyramine work for you too?

  • No, My symptoms are different. I just came across the article and it wasn't something that i had heard of before so posted it here in the hope it would help some.

  • Thanks for that Roz, i will be having a word with my GP about this, as i have suffered for 30 + years to no avail. Have had all the anti-spasmodics etc, fibrogel tried eliminating certain foods and was just about to ask my doc to refer me to the dieticians regarding the FODMAP so it was handy that i checked out the web site before i did. Thanks Anjie

  • Hi Anjie,

    There's a test that can be done for BAD called SeHCAT, but my GP didn't bother with that as she didn't want me to hang about waiting for appointments etc so gave me a trial-by-treatment instead.

    Let me know how you get on.


  • Thanks Roz, i will ask my GP about it, did you suffer with acid reflux at all?? My doc says i have a hiatus hernia but i am beginning to wonder if this could be bile as it burns my throat soooooooo badly and i cant lie down for ages and drink milk like it is going out of fashion and usually take a biscuit to help mop up the acid so to speak.

  • I only had very occasional reflux, but I did have a duodenal ulcer which wasn't caused by H.Pylori (the bacteria which is the usual culprit) and my GP has since said that it could have been caused by too much acid in my system. I also had dysphagia (where your throat feels as if it's closed off when you start to eat). Indigestion and heartburn were also major probs for me, but, apart from taking the occasional Gaviscon tablet when I've really gone overboard, I don't have these problems any more and no more IBS-D either of course.

    Getting the dose of colestyramine right is a bit tricky so if you do get a prescription for it, take my advice and start with a very low dose (quarter sachet once per day before your main meal) and work it up as necessary. I started at the wrong end of the scale and gave myself C plus much bloating for a couple of days. It took me 2 - 3 weeks to get it spot-on, but I'm so glad I persevered.


  • hi RozB , I've just been prescribe cholestyramine tabs today. i feel more positive after reading your post , 'i've had ibs-d for 20 yrs . and could do with a break from it lol . Trisha.

  • Hi Trisha, I think we've just crossed in the post as it were as I've just replied to your question!


  • I've been for a colonoscopy today, which was clear. I asked the doctor who did it if my diahorroea could be related to having my gall bladder out 2 years ago, and he said it definitely could and I should ask for a test. I also get really awful indigestion occasionally.

  • That's fantastic Roz. Thanks for sharing.

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