Questions on Questran and low carb

[nsmith4366]

ANYONE WITH EXPERIENCES OR EXPERTISE OR ANSWERS?

What are the ramifications for this in low carbing while on questran/weightloss?

I currently started taking Prevalite (Questran lite). I had my gallbladder removed and have too much bile in my system/causing problems. I have many concerns questions about this taking this medication----------------------------------
How can I prevent deplation of vitamins A D E & K? Is taking a multi vitamin enough?

Should I take calclium – citrate +D, if I get constipated will this help with that?

If I get constipated, what should I do? Just increase fiber or take a laxative? Which laxative?

Does it make all bile acids inactive or just some? Am I absorbing any fat at all?
If not, why wouldn’t this lead to weightloss?

If I am not absorbing fat/or as much fat, shouldn’t my appetite increase?
Why would appetite decrease?

If it binds bile acids then wouldn’t that mean more fat undigested = diahrea or ?

An increase in bile acids in the system creates itching/stinging (in my crotch area) or “pins and needles” feeling wherever I get warm (crotch if sitting a long while for example). Why is this? Is the trick just to take cool baths if needed? Why does moisturizer stop the sensation? Why does powder help (keeps skin cool?). This sensation stops when taking this medication – does it do so because there is less bile in my system? Yet taking a hot shower does not cause this – is it the warmth and moisture/perspiration that cause the blood to come to this area and create the sensation?
I also find that certain underwear materials must be avoided – I can only wear breathable types of underwear or I get stinging. Moisturizer and powder seem to stop/prevent this. Should I continue with the moisturizer and powder even if this medication stops the stinging?

I read that taking this medication can interfere with other medications. Do those include vitamins, acidophilus and calcium?

If I eat lots of extra fat, can I eat more than the medication will prevent absorbtion and in doing so make sure that I do absorb some fats? Would a higher or very high fat diet help?

Would eating something natural like olive oil help any constipation (instead of bloating Metamucil?).

What happens if I take Metamucil while taking this drug?

Do people gain weight on this medication because they feel they can eat “anything” now and do? Or do they gain because they eat more food over all (primarily carbohydrates) due to the fact that fat does not make them feel full? Will fat make me feel full if it is not absorbed as well?

Is prevalite an insoluable fiber? If so, that would explain the gassiness – but it does not explain the constipation. What causes the constipation? I read that constipation is most likely a side effect in the elderly – is that because they don’t drink enough water? I drink lots and lots of water. Is there a chance I won’t be constipated on this medication?

Some artificial sweeteners, like malitol can resolve constipation (sugar alcohol) – I may have ibs and normally avoid sweeteners like these. Should I continue to avoid these sweeteners or eat them as a pleasant way to solve the constipation?



If Questran blocks the absorbtion of fat - is it possible that an Atkins diet would then become a non-fat/lowfat Atkins diet while on questran WHILE eating lots of fat???

Thanks.

[doreen T]

Nancy, your questions are very overwhelming. I suspect that's because YOU are overwhelmed by all that's going on. Truthfully, your doctor and pharmacist would be your best resources for having specific questions answered in a way that would be most meaningful and helpful for you. What I can offer are generalities, and some links to information that may or may not be helpful for you.

About cholestyramine (Prevalite) ... it can interfere with the absorption of other medications. It's recommended that you take any other meds 1 hr BEFORE, or 4 to 6 hrs AFTER you take the cholestyramine. Fat-soluble vitamin deficiency is seen with long-term use, in persons following low-fat diet, who do not take supplements. Most resources suggest to take a super-potency multiple vitamin & mineral supplement. For more information about cholestyramine and taking supplements, check this article from Healthwell.com (http://www.healthwell.com/healthnotes/Drug/Bile_Acid_Sequestrants.cfm). It includes cross-links for more info about each nutrient. Cholestyramine/ Prevalite is not fiber. It's a resin of various minerals which bind with bile salts in the far end of the small intestine. From what I've read, when cholestyramine is used to treat diarrhea, as it is for you ... then constipation isn't really a problem. The drug will restore regularity to your bowel function, so you can be more comfortable, and have a normal life away from the bathroom!

I have no idea how the drug will affect low-carbing, or how low-carbing will affect the drug. As I stated above, most problems seem to relate to persons following a low-fat diet, since the drug is usually prescribed to lower cholesterol.

Here's the Google search result for Questran and bile salt diarrhea (http://www.google.ca/search?q=questran+bile+salt+diarrhea&hl=en&lr=&ie=UTF8&oe=UTF8&start=0&sa=N). Have a read through some of the articles .. I'm sure there'll be something helpful for you.

Calcium tends to be constipating. However, it normally comes in a tablet combined with magnesium, which tends to be laxative, so they balance each other :)

Regarding your skin and itching ... there are several likely causes .. first, the excess bile salts can irritate from the inside. Plus, if you've been having frequent diarrhea, no doubt your bottom is sore from that too. It sounds like you have a good arsenal of tricks for relieving the discomfort. I suggest you do whatever is right at the time, which may be powder one day and lotion the next. You might even consider a baby cream or zinc oxide, which is very soothing.

I would avoid anything with sugar alcohols like a plague, at least for a couple of months until things have settled down. Sorbitol and maltitol can cause diarrhea and gas because they are only partially absorbed. Therefore, a percentage of the unabsorbed sugar alcohol arrives in the colon, where the bacteria (and possiby yeasts) go wild with it.

I found the company that makes Prevalite. Upsher-Smith Inc. (http://www.upsher-smith.com/product/prevalite/prevalite.htm). Not a lot of info .. they just have the package insert posted on the website. There's no place to email them ... the "contact us" link is for career information :rolleyes: However, there's a 1-800 # at the bottom of the page, so you might be able to call and get some questions answered, especially about the absorption of dietary fat.

hth,

Doreen

[nsmith4366]

Thank you Doreen. Yes, Prevalite/Questran has worked and I do have my life back. I appreciate your response and I'm sorry if I was overwhelming, I'm a little overwhelmed myself. i was hoping someone on this board had first hand experience with both lc and this medication.

I will go to the link/resources you listed and learn learn learn.

Hugs. N