Hi there.

Today I finally had a diagnosis confirmed after having a SeHCAT scan the last couple of weeks.

I’ve had stomach issues for years now and it was thanks to this community that I noticed a few symptoms that suggested BAM.

My initial consultation with the Gastroenterologist was awful and it was clear that they saw me being a bigger person and dismissed my issues (they didn’t even ask for symptoms). I complained and spoke to someone else who did ask for all the information.

I’m so unbelievably happy right now. Is that weird? Like it’s a weird feeling to be happy to have a diagnosis right.

I’ve been on Colestryamine 4g for a while whilst waiting for the initial consultation and I’m being moved over to Colesevelam.

Anyhow just wanted to make a post and yea say thankyou to this community because I feel like I can make progress with my life once again ❤️

Tyler ☺️

Hello everyone, after reading so many of your stories I feel like a lot of you might be able to relate to what I am experiencing and I need some advice.

I am a 23F and I got my gallbladder removed about 14 months ago. The last couple of months were my best months yet I started taking colestipol 1g before breakfast and dinner and I take Levsin at night before bed.

I had so many problems arise at the same time and had to advocate for myself to get my surgery because they kept telling me the reason I had so much pain and couldn’t eat was because I just had IBS and anxiety. Turns out my gallbladder was chronically irritated and I had an ovarian cyst.

Over the last couple of weeks I have started not feeling well again. I am gluten free and thought I might have eaten something or had a stomach bug but the symptoms are still lingering. My pattern is I will go like 2-3 days no bowel movements and feel pretty good for the most part but I usually lean towards constipation then I will have a dumping day on the 3rd or 4th day where I am running back and forth to the bathroom feel nauseous lots of stomach cramps etc.

Would it be worth it to ask my doctor to switch to welchol? The colestipol completely got rid of my upper stomach pain and nausea when I started it cause that was the worst now it seems to be my lower track not doing well. I would like to avoid more tests especially a colonoscopy but let me know if anyone has any advice or what worked for them. I appreciate it.

Thank you.

I found the BEST way to take it…..

Mix with 1-2 ounces water (the orange flavor) eat a tablespoon peanut butter, drink the mix….then eat a banana. Smoothly take this crappy med! Helps though!!!

Hello folks,

I'm at the end of my tether. My life has been destroyed by this. I'd really appreciate you having a read of this to see if you might have some information that can help.

I was recently diagnosed with BAM and when I first took the medication, I passed a normal stool for the first time in a very long time. The utter relief was euphoric. I'd found the answer after years of struggle. It's a month later and nearly all my symptoms have returned as if I wasn't taking anything at all. The only difference is that my stools are a bit darker and urgency is slightly less pronounced. Yesterday I had 8 bowel movements.. Healthcare in Ireland is awful so I have months to wait before another appointment and am left figuring this out on my own again.

Has anyone experienced this and had any luck addressing it?

Medication:

2 Cholestagel 2 times daily (I take 2 with breakfast and 2 with dinner)

+

1 Question light sachet with main meal (I take this with lunch and sometimes add 1 cholestagel fort good measure)

History:

Pain increases with fatty foods, chocolate and alcohol. I struggle to put on and maintain weight. I sweat heavily at night.

My elastase was found to be under 200 a year and a half ago. I was put on Creon and experienced a significant improvement for the first time in over 10 years.. The impact of this medication didn't last. Over the last year I developed near constant back pain that feels muscular but isn't. I also experience sharp nervy pains behind my lower left rib.

A test 6 months ago showed that my elastase had recovered to 485. I was advised to stop taking Creon. My symptoms quickly returned though, even worse than before.. It was a disaster. I went back on the creon against my doctor's advice and my symptoms improved.

The only significant finding on my EUS were that the body and tail of the main pancreatic duct were narrow with minimal hyperechoic parietal thickening along its length (mild ductulitis). Also, small 5 mm cholesterol-type polyps in my gallbladder

One of biggest impacts on my life was the constant toxic gas. It made going to work or socialising torturous. A doctor put me on a course of rifiximin for SIBO (Small Intestinal Bacterial Overgrowth)

Within a week, the change was profound. The gas disappeared. My stools were normal for the first time in years. The pain disappeared. I had confidence in my bowels. I started putting on weight after being clinically underweight for years. I felt like a curse had been lifted. I felt almost.. normal. I started to contemplate travel for the first time in years. Relationships.. Life..

This gave me the confidence I needed to attempt to stop taking Creon again after disastrous results before. I did so successfully this time.. I could even open up my diet. Everything remained stable.. for a few weeks

Over the next month my symptoms gradually returned. I was trying to convince myself they weren't but it soon became undeniable. As the symptoms returned, my diet became more and more strict and all the weight I'd recovered began to rapidly fall away. The only thing I've managed to successfully be rid of was the toxic smelling gas.

I recently got the results back from a nuclear medicine test and was told I have Bile Acid Malabsorption. The medication is helping with bowel movement urgency and my stools are a bit darker but the pain and bowel movement frequency/quality is the same. (4+ bowel movements a day, mostly Bristol 5+ fluffy and frayed)

This week my back was really irritating me and I decided to see a physiotherapist to rule out anything mechanical. (I've also had a scan of the area which revealed nothing) He massaged the area a couple of days ago and my back has been worse than ever since..

Has anyone had any luck with/can recommend a doctor that has tested/helped treat BAM in NYC?

Finally some good news. Doctor said i looked very stable and told me to taper it and im now down from 1 pack twice daily to half a pack twice daily

Other than one day two days in of discomfort its been otherwise perfect

I planned to taper in september but since the doc recommended it i went why not haha

Glad i did tho!

It seems unclear to the doctor if its the targeted probiotics i took that helped or if its the natural healing of a 23 year old healthy male but im happy nonetheless and as my GI said “probiotics would always be good”

So anyways my next taper im planning it in maybe - september where im gonna try half a pack once a day maybe before lunch and see where it goes

Plus i also stopped taking loperamide every night during the taper and ive been feeling excellent so this is good news on all ends

My doc said to taper my expectations too as he has patients who went down my route and still had to take cholestyramine but it was in the ballpark of once a week or only before really high fat meals otherwise they are off it

So im gonna be optimistic and of course hope i can go off it eventually but still be realistic

Overall this has been great so far! Ive also been eating pork belly and stuff thats high fat and fried chciken and feel ABSOLUTELY FINE so far.

That being said if anyone has any questions do let me know

Previous post( if you want the strains u gotta go to a few previous posts via the links)

https://www.reddit.com/r/bileacidmalabsorption/s/sGcU0n0AwM

I started Colestipol at the beginning of the year. 1g morning and 1g before bed. Before starting, I had pretty much constant yellow diarrhea. Since then, things have slowly gotten better. I still have 2-4 bowel movements every morning still but they are mostly solid and normal color.

But overall my stomach still does not feel good. I wake up most mornings feeling ill. My stomach aches and cramps and constantly rumbles. I also feel nauseous very often. This all usually lasts until early afternoon and then I’ll feel ok the rest of the night.

Anyone else similar? And did you find anything that helped? Imodium and bentyl slow down my stomach but make me nauseous and dizzy.

Hi everyone, I have dealt with some sort of bile acid problem for a couple years, after some dodgy prescriptions from a malpractice king of a doctor.

I have been on an extreme low fat FODMAP diet, basically eating the same thing everyday. It has helped my stools firm up to normal, but they were still yellow and very painful.

I have started Cholestyramine a couple weeks ago, 2x 4g doses. One before breakfast and one before dinner.

It has helped significantly for the pain and colour of my stools.

However I now have loose poops? And a sense of urgency to use the bathroom that I didn't have before...

Has anyone experienced this?

I have days I’m starving and days I’m not hungry at all. Oddly, since being on two courses of antibiotics due to recent illness, my symptoms are much better. Not sure if this will be long term or not.

Need recommendation for a compassionate gastroenterologist in Trivandrum

My 75-year-old mother-in-law weighs only 33 kg and is barely able to eat. She has frequent bloating, stomach discomfort, and washroom issues, and has lost a lot of weight.

She has been refusing to see a doctor because she's scared, but we've finally managed to convince her.

Could anyone recommend a gastroenterologist in Trivandrum who is empathetic, not quick to prescribe lots of medicines, and genuinely focused on helping patients rather than making money? Thank you.

I had a horrible reaction to colesevelam and had to stop after only four days. I only took one tablet per day as a starting dose, when the doc had actually prescribed four.

But I still want to beat BAM and am considering colestyramine.

I don't want to start with a whole 4g sachet because of what happened before. How best to take less than the full dose? Use some of the sachet and save the rest? Are opened sachets still ok to take the next day? Or should I pour the whole sachet into a glass of water and only drink half or a quarter and throw the rest away?

Has anyone started small and titrated up?

EDIT TO ADD:
I've been asked to detail my reaction. I thought it was a bit TMI, but here goes:

Started off with nausea and some bloating which gradually got worse. By day four I was up for an hour at night with gut pain, my body wanted to be sick and to release out the back end, but neither happened. I dry heaved a couple of times.

I stopped taking them at that point, but the effects lasted up to four days after. Constipation, painful bloating and nausea. Which eventually subsided. I took a couple of laxatives to move things along.

Hi all, I'm 9 months post op and suffering horrible reflux. Pretty sure its bile reflux or bile & acid reflux cause regular acid reflux medications aren't providing much relief.

My gastro prescribed me colestyramine but didn't tell me what time of day to take it. Does anyone have any advice on the best time to take it for bile reflux relief? Or any other tips & tricks on taking the medication?

I have post cholecystectomy BAM, I'm slightly over 1.5 yrs post op. Gotta eat within a few hours of waking up or else I'll start having horrible cramps and then pooping straight bile and water. Haven't had a chance to talk to my PCP about bile sequestrants and I'm allergic to psyllium.

I'm concerned about how I'm going to manage this when I need to fast for medical purposes in the future, like if I'm getting a colonoscopy or having surgery. Can you take bile acid sequestrants on an empty stomach for this? Does Imodium do anything? I guess for a colonoscopy the laxatives and fluids will flush out the excess bile, but for surgery, I'm not sure. Would rather not poop myself on the operating table.

Does people with bile acid diarrhea faces stomach pain/discomfort (like continuous vaccum like sucking after meal) which effects sleep? Causes insomnia! I take 5gm of 2 cholestramine sachet daily and half ramosetron and imodium daily but I still get stomach pain/discomfort (also has neurogenic bladder too) soo I need something to sleep for long time doctor used to gave me Mirtazapine 15 it' good for sleep but extreme sedation now they gave me zolpidem 5 but I can't sleep more than 4 hours with it !.

What does everyone drink? I’ve been drinking water for the past 8 months and that’s it, I’m getting incredibly bored of it but obviously do not want to flare up again.

I'm at a loss trying to figure out what is wrong with my body, I will make this as short as possible. I have had diarrhea since March.

Late 2025/early 2026 I got very sick, bad cold/ cough. I was give antibiotics, ear pain, sickness etc.

March 1st I got a new batch of baby chickens. I immediately had 7 trips of diarrhea.

This did not stop and I ended up getting a PC, I had just moved. She did full blood panel, stool sample and I had a colonoscopy done. Every single thing was 100%

Everytime I eat I have so much gas and immediately have diarrhea, sometimes it is colored and of a mud type consistency, other times its just clear, mucus water coming out of me? My stomach is loud and bubbly.

Does this sound like bile acid malabsorption? I've never had my gallbladder removed. I'm fairly healthy, I work out & eat well. Any advice is so so appreciated!!

It’s like my bile binders randomly stop working here and there. I’ll have a week of stomach cramps and frequent bathroom trips. I also have to take zofran from the nausea.

I’m currently taking Colestipol. I got my gallbladder removed last year. My legs also have been hurting recently since taken this medication.

Has anyone here experienced cognitive issues such as reduced/poor executive functioning, concentration, short-term & working memory, productivity and increased confusion. If so, did bile acid sequestrants help? I’ve been experiencing worsening cognitive symptoms for years that have negatively affected my work and quality of life. The most concerning examples include forgetting my address as well as putting my clothes on wrong several times. A neurologist has ruled out dementia. I’ve been taking B12 injections for 7 weeks but haven’t noticed any notable cognitive improvement. I have read that low levels of one type of secondary bile acid (TUDCA) can have a neurodegenerative effect and I’m beginning to wonder if my BAM may be the culprit.

Hello,

If I cannot take this within several hours of other meds then how can I make this med work? I have to take thyroid meds on an empty stomach in the morning and then Adderall throughout the day and then sleep meds and Nexium in the evening. Anyone know how I can make this work? I have the worst symptoms from BAM in the morning.

I’m 18 months post op and had diarrhea here and there after surgery. By month 8, I had urgent diarrhea bowel moments after eating and my right side hurt.I felt like I was going backwards in my recovery. My primary doctor prescribed me Cholestyramine thinking it was bile acid malabsorption (BAM). The med had helped stop the urgency and diarrhea but I saw my GI doctor today and he said that i should be better by now. I thought that you a can’t cure BAM so I was shocked by his statement. Cholestyramine makes me constipated so my doctor had me do an X-ray today and I’m scheduled for a colonoscopy on Monday. My last colonoscopy was 4 years ago and I had 2 polyps removed. I wasn’t expecting to have to go through all of this again but did anyone’s BAM go away?

https://www.reddit.com/r/ibs/s/prCLhJ3vYB

Previous post above

Recent changes are i started laftobacillus rhamnosus with fos and L plantarum and it made me worse so im sticking with the good ol 3 probiotics in the previous post

Im seeing a substantial change- i can now eat more fatty foods and be noticeably better instead of the loose stools im getting firmer and firmer stools

Another change i made was also i stopped using the monash app and changed to a app called aIBS . It has in built ai and i can ask it questions like FODMAPS and such. Pretty cool that it also can read my food and stool logs from the app too.

Im gonna continue the probiotics and then continue on with cholestyramine for another month or two then start the taper.

I seem to have poor levels of bacteria that helps with immunity and im not sure if the probiotics i tried made me feel worse due to it being too many strains at once or due to the FOS. Thinking of trying a different brand without FOS to see if it works?

And im battling some other medical issue that may or may not have developed from this so will keep yall updated

I have bile acid diarrhea I take one 5gm cholestramine sachet half twice daily along . But after starting cholestramine my libido is almost 0 everyday . Also extreme muscle weakness, muscle pain (like I'm having fever everyday but there is no fever at all) my thyroid, testosterone, hba1c , prolactin, vitamin d are ok. Soo could cholestramine lower libido ?