Welchol and IBS

I am new to the site, but wanted to give my input on IBS.  I have suffered with IBS all my life and as I have gotten older it has gotten worse.  My doctor put me on Viokase to see if that helped.  It did on some levels, but I was still making sure that if I ate any where but home a bathroom was close by. 

 

My doctor started me on Welchol 3 weeks ago and I feel like a different person.  I can actually go to a new restaurant to eat and not be worried if I will have to go the the bathroom before I am done eating and then another 2 times before we leave. 

 

I wanted to know if anyone else was using Welchol and how it was working.

 

I am taking 6 a day.  Were you taking that large of a dose in the beginning?

Carell,
Welchol is actually a cholesterol med that docs found to actually help absorb the excess bile caused by not having a gallbladder. Excess bile causes yellow, burning BM's. The maker should really advertise it as an anti-bile med as well.

I only take one a day, although sometimes I need to take an additional one or two if my stomach is upset. But there have been some other ladies on here previously who were both taking 6 a day, so it's not unheard of. However many it takes to get up normalized.

does this make your bm's yellow slimy & almost oily looking?

No. what I meant is having to much bile. Will this make your bm's yellow, slimy & kind of oily looking?

I am a new member and I have several questions regarding medications and their usage.

Over the last couple of years I have gradually developed a problem with urgent diarrhea usually shortly after eating.

about a month ago I visited a nurse practitioner for help. After a stool sample to test for parasites was negative, she started  me on Questran. I used it for 7 days(two doses per day) with no noticeable improvement and it also caused heartburn sometimes. The first couple of days started out suggesting some improvement, but subsequent usage indicated basically no improvement.

Following the Questran, I started Welchol initially at 3 pills once a day. The first couple of days suggested some improvement which proved illusory. After 3 days I increased dosage to 4 per day for 3 days, then 5 per day for 4 days, and I am presently at 5 per day. It appears that the Welchol is providing some improvement. On some days it would be up to three hours after eating before having a BM. However sometimes there was very little increase in the time after eating before having a BM. Also, the BM's are more frequently nearer normal as opposed to being almost watery.  What discouraged me yesterday was a day of 5 or 6 liquid BM's.

Let me mention also early in the treatment trials I tried up to 3 imodium pills with no effect except bloating and stomach ache. And also tried up to 2 Lomotil pills with no effect except bloating and/or stomach ache. These symptoms are unusual for me. I don't normally experience these when having diarrhea.

I will mention that I had my gall bladder removed about 25 years ago, but concluded this is not significant since I didn't experience diarrhea for over 20 years.

My questions are:

1. Are my trial periods too short between dosage increases or changing to a different medication?

2. Since the Welchol still suggests some promise, I am considering supplementing this with perhaps one Caltrate 600 tablet per day. Do you think this would be a good move? (I have been reluctant to use too much Caltrate because I had a bout of kidney stones several years ago and my Urologist recommended avoiding calcium.)

I would appreciate your guidance concerning my treatment game plan and also any other suggestions you may have.

With Best Regards,

PT

Hi antsie,

I just wanted to welcome you to the site, so... Welcome to HealingWell! You've come to a great place.
I can't really help you with anti-d meds or Welchol, as I have never taken them, but I'm sure others will be along shortly.
Real quick though, about the Align, it might not be a bad idea to start on probiotics. Most of us here take it in some form or another. I would, however, start 1 thing at a time. If you start taking more than 1 new med/supplement at a time, and you have problems, you will never know which is causing the problems.
One more thing... Calcium can also be taken to help control the bile D.

Dear Antsie:   Thank you for your message summarizing your situation and treatments. I hope the Welchol and Align will help you to improve or resolve your diarrhea problems.   You asked for encouragement and while I am going to mostly report on things that didn’t work for me, I am encouraged to believe I can handle my issues based on what I have learned so far. So maybe you can glean some things from my experience that would of interest to you.   To explain my situation, over the last couple of years I have gradually developed a diarrhea problem manifested by occasional urgent, explosive diarrhea about 30 minutes to 1 hour after a meal. When I am at home this is no problem, but when my wife and I go out to dinner, often with friends, it can be a real problem. I had experienced three episodes of bowel incontinence during a three month period before my seeking medical help in May. But I have improved to the extent that I haven’t experienced any more of these episodes of bowel incontinence more recently.   Let me explain a little further that my wife and I used to travel a lot but have not traveled very much since 9/11. My wife doesn’t want to fly and I don’t like to drive for long periods. So my diarrhea problem has not been a high priority issue and the main reason I started seeking help is that I want to fly on a trip to Washington on September 13. I am a WWII veteran and some benevolent persons in my area ( and I have heard other places in the U. S. ) have started flying WWII veterans to Washington , DC , to visit the WWII Memorial. It is a one day trip, i. e., up and back home on the same day.   So my immediate goal was to figure a way to make this trip without having the diarrhea incontinence problem. With that explanation I am going to enclose some excerpts from 1) a FAX sent to my Nurse Practitioner and Gastrointerologist and 2) an email sent to my adult children which summarizes my situation as of July 31. ******************************************************************* FAX, July 31   This is an update on my situation and a request for your guidance on what I could do next.   Regarding my IBS situation, briefly I am presently "going back to the drawing board". Over the last 6 weeks 1)I have tried a new fiber supplement, Benefiber, 2) tried a new prescript ion drug, Questran, 3) tried imodium, 4) tried a prescript ion diarrhea stopper, Lomotil, 5)tried another prescript ion drug, Welchol, 6) tried a probiotic, Culturelle, and 7)tried a yogurt product, Activa. about one week ago, I experienced 10 diarrhea BM's in one day, and I decided to stop all of these and start over again as soon as I learn a more hopeful course of action.   Some of the things I have learned so far are: 1) I feel better and do better without any of the medications I have tried so far, 2) it takes probably at least one week to stabilize on a new medication before you can make any decisions about results, 3) if worse comes to worse, I can make the Washington trip by just not eating for the 12 hours on the trip. (It is up to Washington and back home in the same day), and 4) I am going to ask my nurse practitioner about seeing a gastrointerologist who specializes in treating IBS. The nurse practitioner I have been seeing is very likeable, easy to talk to, and helpful.   I feel much better right now doing nothing and it is something I could live with this way if necessary.   To update, I haven’t taken any fiber supplement or other IBS medications since June 25, and I have generally done better during this period than when I was trying all the medications. However, during the last 2-3 days I have started getting a   hemorrhoid as evidenced by blood traces. So I feel that I should gradually start some type of fiber supplement again.   Also, I learned recently that I have been selected to for the next Washington trip on September 13. I am scheduled to attend an orientation meeting regarding the trip on this Thursday, July 24.   Ms. (blank): 1) What would be a reasonable next step? 2) Is re-starting a fiber supplement a good interim step at present? 3) Should I schedule a visit to see you?   Thanks for your help, Paul Taylor.   PS- I promise to not tell you any more jokes next time.   Excerpt from Email to my Adult Children, July 31   I saw the nurse practitioner today. I reviewed what has been tried and explained that for about 4 weeks I haven't taken any IBS medication except stool softeners. And I feel fine.   Then I explained that my only goal at this point was to figure a way to make the Washington trip without an episode of bowel incontinence. After a thorough discussion of all the issues she said the only thing she could recommend at this point was to restart use of a fiber supplement. I asked her if she knew of a medical person who specialized in IBS treatment. She said she had been discussing my case with the Gastointerologist for whom she works, and she felt he had some ideas.   So Dr. (blank) came in and we had a good discussion of all the issues and mainly I reiterated that I was doing fine and feeling fine. My only goal was to figure some way to avoid a bowel incontinence on the Washington trip. So he said that he sometimes advises a colon flush to his patients and this would be appropriate for my situation. Prior to this I had always taken a dim view of all the advertisements and rip offs for over the counter stuff they are selling. But he explained to me the mechanics of how this can be helpful from time to time. So I am going to take 8 ounces of magnesium citrate one evening. This is the extreme laxative you take in preparation for a colonoscopy.  He said this would give at least 3 days of being diarrhea free. So I am going to try it, maybe a couple of times, before the trip.   Also I ask both of them about wearing an adult diaper (like Depends). Ms. (blank) said she didn't think it would be necessary, but Dr. (blank) said, "Go for it. It won't hurt anything and could give peace of mind."   Anyway so I plan to gradually use up all the fiber supplement I have and then go back to regular use of Metamucil.   And I feel confident now that I can handle the trip OK.   Also, I was very pleased to get to know Dr. (blank) better. All previous times he had been very hurried and aloof. But this time we had a very good conversation, even discussing a mutual friend. So I was very pleased overall.   Love, Dad   *************************************************************************************************** Antsie, since the above email I have tried the magnesium citrate once and while it did not eliminate diarrhea completely, it did reduce it significantly for about three days.   So I am definitely planning to go on the Washington trip 1)by doing the magnesium citrate thing one day prior to the trip, 2) getting some Depends and probably wear them, 3) select some type of food that I could take with me and possibly declining part of or all the scheduled meals, 4) at my orientation meeting regarding the trip, I alert ed the medical staff person that I had this IBS problem and she is going to have me seated near the bathroom on the airplane.   In the meantime I plan to ask my Gastrointerologist if he has any other ideas for me to try.   And based on some of the reading I have done in researching this problem, I have started doing some exercising of the anal sphincter muscle aimed toward strengthening the sphincter. (This is something I did for my urethra sphincter several years ago when I experienced bladder incontinence following prostate cancer surgery.)   And 7Lil, thank you for your commentary. Good to hear from you again.   PT  

Antsie, thank you for your quick response. Regarding Align, I am not familiar with it. When I asked my medical people and pharmacist for recommendations for the best probiotic to try, Culturelle was recommended. When I did try the Culturelle I didn’t note any results one way or the other. It just seemed to be something neutral.

Have you found that Align eliminates or reduces your diarrhea?

As previously noted I plan to discuss my results with my Gastrointerologist and I will inquire about Align.

Again, thank your for your recommendation and I hope you will find answers to your problems.

With Best Regards, PT

Today I had an "iffy" kind of morning. I had a BM that was not D but one of those deals where you feel like you are not quite done. Then I was racing around trying to get ready for church. Next thing you know I am running late and begin to get a bit stressed about it. Whenever I get rushed like that my stomach gets in knots and I often get the D. Just before I was heading out the door I got that familiar feeling. It was not D though, just needed to go badly. On the way to church I felt a bit crampy but not bad. Once I got settled on the pew my stomach was still not quite right so I reached in my purse and took out a Bentyl and swallowed it right there with no water. Not fun! Soon my crampiness settled down. I ate a sub sandwich for lunch and, took my Welchol and was feeling pretty well then. I have been taking my Welchol at lunch so that my thyoid, Align and other meds that I take at breakfast have time to get absorbed first. At dinner time I was feeling a bit crampy again so I took another Welchol with my dinner. Other than the morning anxiety and the crampiness off and on I had no other issues the rest of the day and no D. Will see how my BM's are tomorrow after having taken 2 Welchol today. Also the gas and bloating that the Welchol was causing me seems to be settled way down since I added Align to my routine.

Hi antsie,
You might want to try increasing your Welchol dosage, as they are to be taken "as needed."
Good luck! Hopefully someone experienced with Welchol will be around with their input.
Hope you feel better soon...

Antsie, I have appreciated reading your messages and have been derelict in not answering your recommendation of Align.

At this point after researching Align further I am going to continue my previous action plan and not try any other medications until after my Washington trip. But I appreciate your concern and recommendation.

I don't want to come across as negative regarding your successes, but I will share with you a couple of my experiences reported earlier. I found that for me it took about a week of trying a different medication or treatment before I could make any consistent evaluations. And also I guess that my optimism lead me to believe that a new medication or treatment was working during the first day or two or three, only to realize after more time it was really not working.

This is not to suggest that we shouldn't keep searching and trying different alternatives but that in my case I had to take a longer time(at least a week) to make any meaningful conclusions.

Again I hope that the Welchol and calcium and Align will solve or at least minimize your diarrhea problem.

With Best Regards, PT