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Gallbladder removal and bile acid malabsorption (anyone?)



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Sorry, this is a bit long and it's getting late (forgive my typos). To avoid the tl:dr reaction -- does anyone take cholestyramine and how did you take it after your WLS surgery? See background details below for more info. Thanks in advance for your comments.

Background --

My gallbladder was removed many years ago as I was finishing college, approximately 18 years ago. Since that time I've been living with chronic bathroom issues, namely diarrhea, that would present within minutes of eating lunch (generally the first meal of the day). It didn't matter what I ate - bread, Soup, iced tea, whatever. I might go once after eating or I might go for the rest of day (too many times to count).

The diarrhea issues would last for several months and then might go away for several months or a year. However, the problem always returned.

I went to numerous doctors about this problem and was always told something like, "you have IBS, or you have spastic colon" or something similar. Last year, I went to my (former) primary care physician armed with my internet diagnosis of Bile Acid Malabsorption. My physician didn't listen again and just said I needed more Fiber. Long story short, someone recommended their gastro doc to me and I went. The gastro doc said, "I know exactly what the problem is..." naturally I had to ask is it "bile acid malabsorption -- the result of my gall bladder surgery?" Ding Ding. That was the answer.

I drink this gritty powder (that does not dissolve) called Cholestyramine (once a day) and my life has changed dramatically - problem solved.

Has anyone else with a sleeve or other WL surgery had this gallbladder related issue and were you able to continue taking your cholestryramine after surgery?

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Following. I suffer for the same thing! My surgery is 2/19 for WL. My mom, who had gastric bypass, and I call it "gallbladder dumping syndrome". So uncomfortable! The only time I didn't experience it was while pregnant - it made my stools normal!

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I am very interested in knowing more about this issue! I have had my Gall bladder removed 11 years ago and My bowls play up all the time !! Even a small take out coffee has me running to the toliet ! I am worried after having my Sleeve done that this will get worse !

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I had the same issue after my gall bladder surgery 7 years ago. I found a pill form of cholestyramine called Welchol and was able to convince my doctor to let me try that instead of the powder. It has worked well all this time and also made my cholesterol amazing. (It's a cholesterol medication.) Before my bypass, I asked my surgeon if it surgery would effect this either negatively or positively. He said probably neither. He also said only about 3% of people get bile salt diarrhea after gall bladder surgery. Anyway, mine has actually been better. I only take 1/2 a pill now and only once every couple of weeks instead of a whole one every day.

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I had my gall bladder removed 5 years ago and suffered for about 4 years with bile acid diarrhea before starting on the cholestyramine, and it works great! Wish I had tried it much earlier. I also asked my surgeon if I'd be able to continue taking it after sleeve surgery and he said he didn't see any reason why not. He did mention that most patients complain of Constipation after surgery, so this could end up being a non-issue. In fact, this has turned out to be the case. I had my sleeve done on 1/07/15 and so far I've only taken 1 dose of the cholestyramine, simply because I thought I "should". I haven't taken any more in the past 15 days and have no diarrhea problems. Now, will that change when I'm able to eat more? We'll have to see. I'm just grateful that the medicine is available for us "3% ers"!

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@gobsmacked @ready2B@Anne BG@@DroppinLikeItsHot

Thank you all for your comments. If I have surgery, I hope my result is similar to what you mentioned (gobsmacked). That would be fantastic to not need the medicine any longer.

AnneBG - the medicines really do help for this problem, at least in my case (and some others on this thread.

Good luck all!

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@@gobsmacked @ready2B@Anne BG@@DroppinLikeItsHot

Thank you all for your comments. If I have surgery, I hope my result is similar to what you mentioned (gobsmacked). That would be fantastic to not need the medicine any longer.

AnneBG - the medicines really do help for this problem, at least in my case (and some others on this thread.

Good luck all!

Thanks No Onions

i am going to give the Medicines a go will chat with my Doctor next visit ! 11 years of running to the toliet, I would love that part to be in the past ;)

Thanks for all the great information all from Australia AnneBG

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How is everyone now? Did your bile acid diarrhea got better after sleeve? Did you still need questran? Thanks

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Yes!!!! It took me Eight years post gallbladder surgery to find an answer to my post gallbladder bile diarrhea. Mostly because it hasn’t been consistent. I could go months without having any and then one day a sip of Water can send me straight to the bathroom. I was sleeved two weeks ago, and haven’t taken my cholestyramine for over a year pre op because I wasn’t having issues. I find it’s much worse for me when I’m stressed or overly tired. Also, the powder is gross, but luckily when I need it I can get by with 1/2 to 1/3 a packet. I was actually planning on asking my surgeon this week about restarting it because I’m having symptoms again post op. I was almost hoping to be constipated post op or a nice change of pace! Lol!! (Sorry, dealing with this actually put in a depression for awhile because I felt chained to my house as I never knew when it would hit so I try to find humor on it when I can)

side note- it may have actually ended up saving my life because the gastro that diagnosed me insisted on a colonoscopy (at 33) and found a significantly large pre-cancerous polyp. I ended up having four colonoscopies in 18 months and am coming up for my two year check this Spring. Point being, if I had waited until the normal age to have one, it probably wouldn’t have been precancerous anymore.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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