Bile reflux is clinically known as duodeno-gastric reflux; this occurs when your bile moves upwards into your food-pipe or esophagus. It is often mistaken with another medical condition known as acid reflux or GERD. The key difference between these two is – in case of GERD (acid reflux), acids in your stomach climb up the food-pipe; on the other hand, bile reflux makes acids present in your small intestines to move upwards. When you are living with bile reflux, heartburns as well as pain in top part of abdomen are commonly experienced. Can you use bile acid sequestrant – cholestyramine – for treating bile reflux? It is essential to know more on this.

Bile helps digest lipids and fats; it is stored in your gall bladder. The bladder provides this digestive fluid to the duodenum for this purpose. A sphincter located in the pyloric part prevents biliary fluids from reaching your stomach and / or esophagus. However, when the pyloric muscle stands damaged or is malfunctioning, biliary fluid may enter into the food channel. A small percentage of biliary-spill into the food pipe or stomach is considered as a common phenomenon; but, a sizable influx can cause swelling and other discomforts such as pain, irritation, etc. If left untreated, reflux of bile juices can trigger formation of ulcers, a severe bout of gastritis as well as cancers in your gastric tract.

The typical signs of bile reflux gastritis include an increased production of saliva, indigestion, vomiting of bile as well as an acute pain in your abdomen (especially, the top portion). In some cases, a few people have noticed frequent spells of heartburns or reflux. Clinical studies attribute a likely connection between obesity (being overweight) and this bile condition.

Treatment of bile reflux gastritis with cholestyramine – a bile acid sequestrant

Medicines forming part of the genre called bile acid sequestrants disrupt the acidic condition by inhibiting presence of excessive acids. Owing to a short supply of acids, your liver starts making more acids using fats or lipids. Cholestyramine is a key member of this family of drugs. Apart from bile reflux gastritis, this drug is also used for treating excessive build-up of cholesterol (mainly, low density lipoproteins – LDL), reducing the accumulation of bile acids in your skin (which may cause conditions like itchiness / pruritus) as well as for a super-optimal secretion of thyroid.

Cholestyramine is one of the widely used drugs for the management of bile reflux gastritis. The drug helps sequester biliary fluids; thus, it minimizes the quantum of such fluids and ensures that they do not get reabsorbed into the stomach. Typical dose of this drug is maintained in the range of 8 g within a day; the maximum permissible intake is always lower than 21 g within a 24-hour timeline. Some people take enhanced dosages of cholestyramine; such overdoses can result in severe side effects such as inflammation of facial parts – like nose or lips; some have also observed swelling of oral organs such as throat, tongue, etc.

A few things to note before starting to consume cholestyramine

Those who have any known allergies to the active ingredients of cholestyramine need to tell about such conditions to their caregiving team. The active ingredients are capable of triggering irregular bowel movements (resulting in difficulties to discharge stools or constipation), bloating of tummy, abdominal discomforts such as vomiting and nausea.

As this drug is likely to interact adversely with a few other meds, inform your caregiver about all the drugs you are presently consuming. In order to avoid acute spells of constipation, it is highly recommended to consume additional amounts of fluids. You may consider taking fruit juices or water; however, keep away from caffeinated or alcoholic drinks. Those who have had a part of their bowel removed off (surgically) are advised to take more precautions. Also, those living with Crohn’s disease will need to take added safety measures. In a very small segment of people, very acute side effects such as blood in stools, erratic bowel movements and a few other abdominal discomforts have been observed. If you need to know more about the likely risks, talk to your treating doctor as well as your pharmacist.

Other needful precautions related to the intake of cholestyramine

Always remember to adhere to precautions and instructions of your caregiver. This drug is neither consumed as a self-medication med or as an over the counter (OTC) med. Ensure to produce the treating physician’s prescription each time you go for a drug-refill. Also, talk to your medical team about safe dosage levels. Those who took excessive doses of this drug developed a few acute signs; these include breathing problems such as gasping, wheezing, shortness of breath, etc. Those who are old or elderly may witness severe episodes of drowsiness as well as dizziness.

Last but not the least, no two people with bile reflux gastritis may experience the same type of symptoms and signs. Similarly, no two individuals are prescribed with the same dosage plan of this drug. Your medication plan depends on unique factors like your gender, age, pre-existing ailments, and above all – how your system responds to the initial dosages. If you turn allergic to this med, and if you are living in the US, dial 911 at the earliest possible time. As an alternative, you can also reach out to the emergency helpline numbers of the food and drug administration (FDA). Those who live in a Canadian province can ask for clinical help through Health Canada; Canadians can also talk to a local poison control center which is situated closer to your home.

In sum, cholestyramine is indeed one of the commonly prescribed meds for treating bile reflux gastritis or bile acid diarrhea. Standard dosage is maintained in the range of 6 g to 8 g in a 24-hour time interval. Beware of side effects like constipation or difficulties to pass stools; some people may feel extremely dehydrated and may develop dryness of skin, lips, etc. It is hence highly recommended to take a lot of fluids – such as water or fruit juices – while taking this medication. Allergic reactions associated with the intake of this drug may include swelling of organs, respiratory problems, etc. In general, you are advised to consult with your treating physician and pharmacist prior to starting your medication plan for treating bile reflux gastritis.

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