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Have Chronic Diarrhea. Illeal Cecal Valve Removed. Put On Questran. Changed To Colestipol. Same As Questran?

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Posted on Tue, 29 Oct 2013
Question: I have chronic diarrhea due to having my illeal cecal valve removed due to an obstruction in my illeal region from radiation treatments 30 years ago for ovarian cancer. My doctor tried me on Questran (but I couldn't get it down because of the taste). So I found Colestipol (pill) and am taking 2 a day. So far, it isn't helping? Is this the same as the Questran?
doctor
Answered by Dr. Pavan Kumar Gupta (1 hour later)
Brief answer...Both the drugs work similarly but are different.
Detailed answer...
Cholestyramine (Questran ) and COLESTIPOL,both are bile acid sequestrants,which bind bile in the gastrointestinal tract to prevent its reabsorption. 
Cholestyramine removes bile acids from the body by forming insoluble complexes with bile acids in the intestine, which are then excreted in the feces.

Both the drugs  are primarily used to treat hypercholesterolemia, but can also be used  to prevent diarrhea in patients who have undergone ileal resection. The terminal portion of the small bowel (ileum) is where bile acids are reabsorbed. When this section is removed, the bile acids pass into the large bowel and attract water due to their osmotic effect, causing diarrhea. Both these drugs  prevent this increase in water by making the bile acids insoluble and osmotically inactive. 
Recently a new drug called as COLESEVLAM has been introduced which is in tablet form and also has much better affinity for bile acids as compared to QUESTRAN  or COLESTIPOL.
I hope it helps however you may revert to me for any further query.
Best of luck
Thanks 

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pavan Kumar Gupta (6 hours later)
I have been taking the colestipol for 1 week now (2 - 1gm tablets/day) and I haven't seen any improvement in the diarrhea yet? Does it take a while of being on this before I would see any results? So much of my food comes out so undigested? I recently purchased some digestive enzymes, as I have read that this could help to digest my food better, but I don't want to start on that now, as I won't know which is working (or not working)? I also do not know how much of the digestive enzymes to take? I know that fat malabsorption is a big problem for me. I try to avoid fats as much as I can. But, when I do eat somethings that have fat in them, my stools are loose and a goldish color?
doctor
Answered by Dr. Pavan Kumar Gupta (35 minutes later)
Hello,
COLESTIPOLE takes many weeks to show its effect.
Make sure that you take this medicine with adequate amount of water.
Also make sure to take adequate quantities of VIT A,D,E and K.
You must restrict the fat in your diet.
Thanks
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Pavan Kumar Gupta

General & Family Physician

Practicing since :1978

Answered : 6704 Questions

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Have Chronic Diarrhea. Illeal Cecal Valve Removed. Put On Questran. Changed To Colestipol. Same As Questran?

Brief answer...Both the drugs work similarly but are different.
Detailed answer...
Cholestyramine (Questran ) and COLESTIPOL,both are bile acid sequestrants,which bind bile in the gastrointestinal tract to prevent its reabsorption. 
Cholestyramine removes bile acids from the body by forming insoluble complexes with bile acids in the intestine, which are then excreted in the feces.

Both the drugs  are primarily used to treat hypercholesterolemia, but can also be used  to prevent diarrhea in patients who have undergone ileal resection. The terminal portion of the small bowel (ileum) is where bile acids are reabsorbed. When this section is removed, the bile acids pass into the large bowel and attract water due to their osmotic effect, causing diarrhea. Both these drugs  prevent this increase in water by making the bile acids insoluble and osmotically inactive. 
Recently a new drug called as COLESEVLAM has been introduced which is in tablet form and also has much better affinity for bile acids as compared to QUESTRAN  or COLESTIPOL.
I hope it helps however you may revert to me for any further query.
Best of luck
Thanks