# Welchol(Colesevalam)



## jmc09 (Oct 5, 2009)

I have read a few success stories both on here and other places on the web about Welchol(Colesevalam) or Cholestagel as its called here in the UK.Its used as a bile binding drug for people without gallbladders to prevent diarrhoea. While i would expect a few success stories for people without gallbladders have any people who still have their gallbladders had success with it also?Looking forward to your responses.


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## jmc09 (Oct 5, 2009)

Just been given this drug,colesevelam/welchol yesterday and I would like to ask other users how long it took to make a difference to their IBS D symptoms.Thanks


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## BQ (May 22, 2000)

Here is an old thread about Questran (powder form) hopefully you can glean some info from it:http://www.ibsgroup.org/forums/topic/139395-cholestyramine-questran/page__p__829056__hl__questran__fromsearch__1#entry829056I think it pretty much shows a difference within a week at least... but as you know... everyone is different.Here's hoping it helps you real soon!


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## Mr 100 (Aug 1, 2011)

Hi jmc09,Which cholestagel have you obtained?I am also in the UK and use the Genzyme tablet, 625mg, purely for ibs-d control.I would advise that you phase these in gradually, perhaps start with one per day. I have found the best time for me to take the tablet is after breakfast.Be wary of building up your dose too quickly, as i have had constipation after increasing dosage. If you find you need more than one tablet per day, spread these out over the day [probably at meal times] rather than take them together.I don't take these every day, as i'm now following the fodmap diet, and don't need to since reducing high gluten and products containing lactose and excess fructose has reduced my ibs-d symptoms.Do research this drug on the net. Although this has been proven over many years [for example, to reduce cholesterol] and seems well tolerated there are potential side effects that you need to be aware of, eg intestinal blockage.Good luck. And please share your experience/ask any questions!


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## jmc09 (Oct 5, 2009)

Mr100,thanks for the info. I'm also in the uk and i'm using exactly the same tablets as you and for exactly the same reason too.I've started on the full dose already,3 with breakfast and 3 with my evening meal and over the first 2 days i'm not anywhere near constipation yet. This would be great as then i could find the right dose for me by experimenting.I have been using codeine for the past year and these help but not until ive had multiple morning BMs and they are not something i like taking long term.I have the luxury of trying Rifaximin next but i'd prefer cholestagel to work as they are easy to take and have milder side effects too.How long did they take until they were effective for you?BQ i tried Questran in sachet form and it was ineffective although i only took it for a few days as i didnt like taking it in sachet form,i find taking tablets a lot easier.


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## BQ (May 22, 2000)

> BQ i tried Questran in sachet form and it was ineffective although i only took it for a few days as i didnt like taking it in sachet form,i find taking tablets a lot easier.


I was only showing you that other thread so you could get some ideas of how it (a bile salt binder) worked for others.


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## Mr 100 (Aug 1, 2011)

Hi jmc09. they started working within a few days for me.The first time I had constipation in years was using cholestagel[1x tab/per day] and calcium [3x half 600mg tab/day] together. A very novel experience for me, but the novelty soon wears off!Once I had to resort to a manual stool removal method, to get things moving again. [ugh!]i think if you want to take 6 a day you would get more benefit from 2x tabs 3x a day than 3x tabs 2x a day. This reduces the potential for blockage and increases excess bile absorbtion.


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## catarific (Oct 6, 2010)

I do not have gallstones and the Welchol worked for me after taking it for over 6 months. But, if you have IBS - the IBS I think will not go away - it will morph. I have had IBS-C for years (since I was a child). In September, 2010 - I either had an intestinal flu or food poisoning - I was very, very, sick. From there, my IBS turned to strictly IBS-D and I no longer could eat all the things I could before and lost a great deal of weight (around 30 pounds) and became painfully thin due to not being able to absorb the food I tried to eat. All of this evolved and started to get better although I still had diarrhea but not as bad as I had when this first started. My doctor put me on Welchol - 2 tablets per day - and as I said, after 6 months, the consistent diarrhea has stopped - but now I have alternating IBS where some days I do not go at all and then I might have a flareup for a few days, have diarrhea and then back to the C. I no longer take the Welchol since I do not have consistent diarrhea - but I know it helped me get to this point. If I am careful with my diet - my IBS is barely noticeable - but it is not cured - just under control.


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## jmc09 (Oct 5, 2009)

BQ,thanks for that info I have read up on how bile acid binders work i just wanted some personal experiences about how theyve effected others so i can get a better idea on how i know if things are working or not.Mr100 i was thinking about 2 tabs 3 times a day as there seems too big a gap between doses for my liking.Do you take them in the middle of a meal or afterwards? I've tried both but not sure which is better.Catarific,getting my ibs under control would be a nice feeling for me too.Does the increased bloating caused by the Welchol ever go away?


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## Mr 100 (Aug 1, 2011)

hi jmc09,I will stick my neck out here and say I think you're doing too much too soon.The bloating is a bit of a problem with cholestagel which is why i would suggest that the dose is best built up slowly over time. this will allow your body and alimentary canal time to adjust to the new regime!You will have to experiment to see what suits you best. I think that spreading out the intake is a good idea. perhaps one at the beginning and one at the end of a meal? Drink plenty of fluids.With regard to diet, stick to low fibre, low fructose. If constipation becomes a problem, reduce the dose, and increase natural laxatives eg citrus fruits.


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## jmc09 (Oct 5, 2009)

Good suggestion Mr100,i think i may cut back to maybe 1 with each meal and then two and see if that helps. The bloating has been a major problem but they havent done anything to ease my IBS yet.


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## Mr 100 (Aug 1, 2011)

hi jmc09, I read some of your posts elsewhere and you seem to have ibs-d a bit worse than me and i can understand your need to get control asap. How's it going with the cholestagel?It occurred to me, following on from my earlier post about me getting constipated, that in order to sidestep some of the bloating, you could try a combined approach with cholestagel/calcium. Presumably you have tried the calcium/vitD3 before?I was thinking perhaps 1 cholestagel and half [600mg] calcium 3x a day?


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## jmc09 (Oct 5, 2009)

Ive had to give the cholestagel a rest for a couple of days as it was giving me terrible bloating and nausea along with looser BMs.I have tried the calcium/vitamin d combo with no luck in the past.I'm a bit pessimistic that this treatment going to help to be honest as treatments that help me usually only take a couple of days to improve my condition.


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## Mr 100 (Aug 1, 2011)

hi jmc09, sorry to hear you have had probs with the genzyme product. I am not completely surprised, at the dose you started taking. Try one a day, and let some time go by... I still think there's some mileage to explore in the combined supplement approach. I would always include calcium as part of a combined supplement for ibs-d. Have you tried any products containing the probiotic saccharomyces boulardii? [actually a tropical yeast] I have had good results from the optibac bowelcalm product. This works really well for me when poo gets too liquid. one tab 3x aday, again, with meals. I can buy this in my local chemist.just as a matter of interest have you gone through the complete diagnosis of exclusion for ibs-d?ie blood tests, colonoscopy etc?


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## jmc09 (Oct 5, 2009)

Mr100,again thanks for your reply.I have been through every test available concerning IBS since my diagnosis in 1992,colonoscopies,the most recent only a couple of months ago,endoscopy,lactose intolerance tests,sibo breath test,ultrasounds etc and i'm being treated by a Prof Peter Whorwell who is a world expert on IBS.I actually tried optibac saccromyces boullardi for a couple of days and it helped with bloating a lot. Its difficult for me to pay for things so i could only pay for a couple of days worth of them.


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## Mr 100 (Aug 1, 2011)

hi jmc09, I have followed the work of Peter Whorwell at S. Manchester, it's good to know you are in the hands of someone who takes functional GI problems seriously. The information, particularly dietry info on their website has helped me. I have started the low fodmap diet, about two months ago. This suits me well and has removed gluten, excess fructose, lactose etc. I'd recommend it.Yes, S. boulardii is expensive, optibac do a large pack at a slight discount. Perhaps if you approached them in the right way they would send a sample to try?


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## catarific (Oct 6, 2010)

I have to say with the Welchol I was NEVER bloated at all. But it did give me gas at times. Actually when I had IBS-C prior to this, I was always bloated - but when it turned to IBS-D that was never a problem not even with the Welchol. I had recently gone to my GI and asked him how to avoid the flareups and he suggested taking Rifaximin. He gave me samples and told me to take a half of pill for 12 days. I took the first 1/2 and had terrible stomach cramps. I took another half the second day and the cramps were worse and I had the urge to go the bathroom but there was nothing there except some mucous. After the second day, I just stopped totally because of the effects the medication had on me. I continued with the mucous and unsettled stomach ache for about 5 days afterward and was constipated for almost 7 days feeling horrible. So before taking Rifaximin, which is a very, very strong and expensive antibiotic, do try other means. I do not mean to scare you but I think it is worth knowing about the after effects of such a medication. When I did have this reaction, I did look up the medication on the internet to find that what I was experiencing was not uncommon. I would rather deal with occasional flareups than this!


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## jmc09 (Oct 5, 2009)

I have handled some antibiotics very,very well and this might indicate that Rifaximin could be suitable for me. Its obviously not suitable for you cat so its good that other things are. At the moment i am struggling with urinary system problems that are putting my ibs on the back burner but its massively frustrating to have two problems simultaneously that have a big effect on quality of life.


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## Mr 100 (Aug 1, 2011)

hi jmc09, you have my sympathies for having to deal with other health issues at the same time as severe ibs-d. Hopefully your nausea and bloating as a result of cholestagel have resolved by now. [i also have the 'joy' of other health problems on top of ibs-d]Do consider trying the 1x cholestagel and 3x [half initially] calcium combination afresh, as i am convinced of its potency.good luck on the antibiotic route, if that is next on the agenda!


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