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Gluten & Dairy
Life With Bile Acid Diarrhoea
Loperamide (Immodium) is used to slow down the bowels and is often used in conjunction with a bile acid sequestrant.
Everyone responds differently to the bile binding medication due to the type and severity of BAD you have and whether you have any other medical conditions particularly ones that affect the bowel such as Crohn's and ulcerative colitis. In addition many of us have found that dietary intake can play a significant part in adjusting to the medications and have found that changes to our diet along with finding the right doses of bile binder has had a positive impact on our symptoms and how we feel..
Some people find that their symptoms quickly improve following commencing bile binding treatment whilst others find that it can take up to 3 months before they identify the right dose and regime that suits them. If you are finding that it is taking time to adjust to the prescribed bile binding medications and are not seeing an improvement in your symptoms it is important that you discuss with your GP and/or Consultant's team to review your progress. It may be that you require an increase /decrease in the dose prescribed, a different type of bile binder, additional medications to help manage your symptoms or further adjustments to your diet.
For some people the timing of when they are taking the bile binders needs adjusting, some find that one dose a day works whereas other have a better response to splitting the dose to two or three times a day or taking the whole dose at night prior to going to bed. Whilst you are adjusting to your medication it is worthwhile keeping a log of your bowel motions to enable you and your GP/Consultant to analyse your stool frequency, types and identify whether there is any time of the day when your symptoms are worse. Monitoring sheets, as well as a clinically approved reference guide, can be downloaded and printed from here.
Ensuring that you do not miss taking your bind binders is really important as symptoms return very quickly. For some of us the impact is fairly quick within hours / same day. For others the impact can be the subsequent day. Most of us find that if doses are missed it takes a few days / weeks for the symptoms to resolve. Keeping a supply of the bile binders in your handbag and wallet is a good idea so if you forget to take them before you leave the house you have some with you. Some of us keep a larger supply in our cars (which we rotate to ensure they do not go past the expiry date) so if we go away with work or for the weekend and forget to take our medication we have an emergency supply. Ask your GP to prescribe a couple of weeks extra supply so you can have an emergency back up in places that work for you.
We have also found that we need to drink plenty of fluids and that the bile binders are more effective when we are well hydrated.
ADJUSTING TO THE MEDICATION
The three main medications used to treat the symptoms of BAD are Colesevelam (Cholestagel),Colestyramine (Questran & Questran Light) and Loperamide (Imodium).
Primary Medications used in the treatment of Bile Acid Diarrhoea
Colestyramine is a powder bile acid sequestrant that is often used as the first treatment for BAD.
Colesevelam is a tablet-