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  #1   ^
Old Wed, May-08-02, 05:09
nsmith4366's Avatar
nsmith4366 nsmith4366 is offline
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Default EXPERIENCE WITH QUESTRAN/Darvocet?

If anyone has first person experience with the bile absorbing drug QUESTRAN or Darvocet please post your experience here. Please include dosage and side effects if any. Thanks.

Nancy
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  #2   ^
Old Wed, May-08-02, 05:24
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nsmith4366 nsmith4366 is offline
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Default To Doreen T

I am having serious weightloss - not due to diet anymore/am seeing a specialist for testing related to IBS/gallbladder removal and too much bile in my system. It is just as you say - all my symptoms are due to excess bile in my system. What I want to know is why does this produce weightloss? They want to put me on Questran to absorb bile in my system, a side effect of this drug is - weightloss. ? I'm a little confused. If the diahrea slows and I then have less bile in my system - why would that lead to weightloss?

Too much bile.
High fat diet I get D and don't seem to be digesting fats well at all, however I lose weight.
Lower fat diet I get C and have that hemmrd's, acidic burn I was talking about and weight gain.

Right now I stick to high fat, no pain and D.
If I have too much bile in my system doesn't that mean that I have enough bile to digest fats? Or ?
Too little bile and it seems like the fat content digested would be less and I'd lose, but I gain.

?? Can you straighten the relationship of bile/weightgain-loss and how the drug questran plays a role?

Please detail as much as possible, yes, I've searched the web -
nothing explains the details to me. You always do so so beautifully.

I'm seeing a specialist to be tested now...colonoscopy etc. I appreciate you and your knowledge so much - will help others I am sure.
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  #3   ^
Old Wed, May-08-02, 18:38
doreen T's Avatar
doreen T doreen T is offline
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Plan: LC paleo/ancestral
Stats: 241/188/140 Female 165 cm
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Progress: 52%
Location: Eastern ON, Canada
Lightbulb

hiya Nancy,

I posted some info about Questran in your journal, but I'll put it here as well in case there are other readers interested. I've never taken it myself, so can't offer any experience or anecdotes about it ... hopefully someone else may be able to help in that regard.

Questran

It was one of the first-line of drugs used to lower cholesterol levels, but has fallen out of favour since the development of newer drugs. How it works .. it binds to bile salts in the intestines which prevents them from being re-absorbed further along in the digestive tract Re-absorption of bile salts is the normal process, but if you're diagnosed with a problem that causes too much bile salts in the blood, then you'd need to take measures to reduce that. The big problem with Questran is that, because the bile salts are inactivated, your body can't properly digest fats. Meaning, you might not be able to break down and absorb essential fatty acids, nor absorb fat-soluble vitamins. Many of the listed side effects are a result of deficiencies of fat-soluble vitamins ... A, D, E and K. And, although it reduces levels of cholesterol and bile salts in the blood, there's a rebound effect of stimulating the liver to produce MORE cholesterol (since you're not absorbing any that you eat) and also increases triglyceride production

Questran is usually prescribed for cholesterol-lowering purposes, but is sometimes used for other liver and bile problems, such as diarrhea due to excess bile production, (which can happen after having the gallbladder removed). Here's an article from iVillage.com about using Questran for Diarrhea after Gallbladder surgery.

Doreen
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  #4   ^
Old Wed, May-08-02, 18:38
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doreen T doreen T is offline
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Plan: LC paleo/ancestral
Stats: 241/188/140 Female 165 cm
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Progress: 52%
Location: Eastern ON, Canada
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Darvocet info

Combination of darvon (propoxyphene) and acetaminophen, pain reliever.

Most sites list cautions against prolonged use, since propoxyphene can be habit-forming, even addictive. A few rare side effects of rashes, nausea ...

Acetaminophen, on the other hand, does have some significant side effects with prolonged use or when taken with alcohol. In particular, liver damage .. you can read more about that problem here ... Acetaminophen (Tylenol) Liver Damage.

Doreen
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  #5   ^
Old Wed, May-08-02, 19:43
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nsmith4366 nsmith4366 is offline
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Thanks! I know this is not about low carbing specifically, still I thank you all the same.

I have too much bile in my system now - and I've D and am losing weight. It would seem to me that I although I am ABLE to digest fats with the bile I have, it is all moving too fast through me to absorb the calories/nutrition and so I have D and lose weight. I am always hungry and eat tons and tons of fat - TONS...washes right through me.

With the questran, from what you say it will de-activate (you know what I mean) the bile salts...and fat won't be digested at all well, and gosh wouldn't that mean more D and more weightloss? I read the weightloss is a side effect from questran as is hemmorhoids (from the D?)

I'm grasping at straws here. I might be beyond what you know, perhaps someone else can chime in?

OH I JUST READ THE LINK/VERY INFORMATIVE!!!!!!!!

Help. I'm in the process of being treated, investigative tests to be done soon to clear it all up - get help. I love my diet and WON'T change it...that's one thing for sure.

Thanks again. N
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  #6   ^
Old Wed, May-08-02, 23:46
doreen T's Avatar
doreen T doreen T is offline
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Plan: LC paleo/ancestral
Stats: 241/188/140 Female 165 cm
BF:
Progress: 52%
Location: Eastern ON, Canada
Lightbulb

hi Nancy,

I've merged your other post (to me) in with this thread. That will keep all the bits and pieces together for you in one place, instead of having threads and posts (and replies) in different places. And also since they're related topics.

From the reading I've done so far, it seems that the problem of diarrhea after gallbladder surgery affects about 20% of persons who have their gallbladders removed. Although it's most likely to occur within the year of having the surgery, there are cases where the diarrhea comes on suddenly years after the gallbag has been removed. The "excess bile" theory is just that, a theory .. but the gastrointestinal experts seem to agree that it's a likely culprit for 5 - 10% of patients after gb surgery.


OK, here's a bit of explanation what is going on in the body:

Between meals, bile from the liver is stored in the gallbladder, a little sac beneath the liver. When you eat, the gallbladder squeezes and releases the stored bile into the small intestine to help with digestion. After food is digested and absorbed, the bile salts are reabsorbed at the end of the small intestine and recycled to be used over and over again. However, when the gallbladder has been surgically removed, the liver must make more bile, and more gets released into the small intestine between meals, because there's no place to store it. The increased amount of bile can sometimes overwhelm the small intestines' capacity to reabsorb the bile salts. The excess spills over into the large intestine, or colon, where bile salts act somewhat like a laxative or irritant, leading to diarrhea.

Why some patients develop this side effect after gallbladder surgery and others do not is still a mystery. Unfortunately, there's no way to predict before surgery who will develop this problem afterwards. Having this side effect does not reflect on the skill of the surgeon or how the surgery was done. It's really just bad luck.

Since there's no specific diagnostic test for this condition, your doctor must confirm her/his suspicion that bile salt diarrhea is the culprit by ruling out other possible causes of diarrhea such as infection, colitis, cancer, and others. Blood and stool samples will be taken, and usually a colonoscopy is done, so the dr. can visualize and likely take small biopsy samples of the lining of the large intestine (colon)

There's no cure for this problem, so treatment is usually geared to lessen the symptoms of diarrhea and urgency. The mainstay of treatment is Questran (detailed above) ... also called cholestyramine resin. There are other brand names as well .. Locholest, Locholest Light, Prevalite, Questran Light. It The dose required to treat this condition is less than for cholesterol-lowering, usually only once a day.

In addition to using Questran, some patients with bile salt diarrhea find that they are helped by the use non-prescription medications to lessen diarrhea such as Imodium. Imodium can be safely taken several times a day. The main side effect, of course, would be constipation. Some patients find that the use of fiber supplements may help make the bowel movements more formed.

You especially want to ensure that you're well-hydrated. You're losing fluids with the diarrhea, and minerals too, especially potassium. You are likely digesting and absorbing at least some of the fat you eat, since the problems of the bile salt irritation aren't happening until the large intestine, and fat absorption takes place in the small intestine. So, do ensure that you're eating adequate fat. A tablespoonful of oil is better than a teaspoon Eat the skin with the chicken, and use whole eggs, not just egg whites. Egg yolks are rich in lecithin, which helps the liver to process fats into fatty acids (not the same as the bile function )

Doreen
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  #7   ^
Old Thu, May-09-02, 00:09
doreen T's Avatar
doreen T doreen T is offline
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Posts: 37,202
 
Plan: LC paleo/ancestral
Stats: 241/188/140 Female 165 cm
BF:
Progress: 52%
Location: Eastern ON, Canada
Lightbulb

I added to the title of the thread as well, so that other persons reading might have some experience to share

I've already mentioned to you some reasons why diarrhea can lead to weight loss. Doesn't always have to be due to bile problems .. the Big D can lead to weight loss whatever the cause of it is.

First is dehydration and fluid loss. Second is malabsorption, due to the semi-digested food moving through the intestinal tract so quickly. Another reason is, if there's inflammation or irritation of the lining of the intestine ... first, this will compound the poor absorption problem AND .. the inflammation will mean that increased nutrients are required for healing. The inflammatory process uses up a lot of calories! And protein.

I was thinking you might consider using a protein supplement ... micro-filtered, isolated pure whey protein could be good. Yes, it's dairy ... but the main protein in dairy that causes all the problem is CASEIN, and in the better quality whey isolates, every last trace of casein has been filtered out. Whey proteins are tolerated even by children and persons who are otherwise "allergic" to milk products. Plus, they are readily and easily assimilated by the body, not a lot of digestive process needed. Just something to think about. If whey is out of the question, then you can get pure egg protein (not powdered eggs .. this is protein isolate). There's always soy protein, but I think it would be harder to digest.

You might also think about taking L-glutamine as a supplement. It is very healing and replenishing to the lining of the intestinal tract. In Protein Power LifePlan, the Eades recommend up to 20g per day (divided) for healing Leaky Gut Syndrome. Good quality L-glutamine powder is completely tasteless, and dissolves readily in water.

Doreen
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  #8   ^
Old Thu, May-09-02, 02:43
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nsmith4366 nsmith4366 is offline
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Doreen,

YOU ARE WONDERFUL. I understand now so many things. I understand why I am losing weight (D) and WHY I have (D)! I understand why an EXTREMELY HIGH fat diet works wonders for me. I understand why taking benefiber (soluable but not bulk forming) promotes D and now I take psyllium along with it - IMMEDIATE RELIEF from D - wow. I understand that I have too much bile in my system and eating fat will help lessen that, however it does promote D in me and causes more weightloss.
I'm nearing 100 pounds at 5'4". I hug you Doreen. As you know, I've been struggling to understand what is going on with me. For a while I though it was yeast related/NOT anymore. You and everyone else now can see how the Atkins diet has HELPED me so much since so many other ingredients in carby processed foods would not only be WAY too low in fat to make me feel better or contain "triggers" and "irritants" for my system (pepper, alcohol, caffeine, sugars, fermentable starches (gas) - and more all very irritating to sensitive intestinal tissues. I've had burning and puritis ani too -and so embarassed asked about that here. You suggested to eat more fat to absorb the bile and I DID and it worked!!! I was getting those rashes NOT due to yeast - but due to the side effect of eating a diet with not enough fat to absorb the bile/effecting my skin in that area. I understand now that these tests they are going to do will eliminate other problems that could be causing this - despite the fact that these symptoms started immediately after gallbladder removal in 2000.
Once eliminated, they will give me Questran and I will try that for a while, but if I prefer just to eat an extremely high fat diet I may not continue to take it and just manage my condition with the wonderful Aktins diet and psyllium...people have done that successfully before, but you must continue to eat frequent high fat meals and snacks all day. I have heard good and not good things about questran.

So Doreen. Through your information and my WAY overthinking of this problem - it's clear. I have too much bile in my system due to removal of gallbladder and should either be on questran or continue high fat diet and just live with the D, which I don't mind all that much, but I don't think it's very healthy - I do supplement with potassium and a great multivitamin low in magnesium (promotes D) with extra B vitamins. Too much vitamin C (megadoses) can also promote D. I found an excellent website that will help anyone with my condition IBS or other conditions :

http://www.ibsgroup.org/main/drugs.html

I have learned SO SO much. So, this is not totally NON-atkins related. In fact it is EXTREMELY atkins related because staying on this high fat diet has helped me tremendously/lessens pain inside, while promoting weightloss. Now D is not a healthy way to lose weight, but when I started eating all that fat my skin, hair and nails became beautiful and yes, fat does make me feel full (not for very long, but it does) so yes, I am absorbing some fat - yes and I think that is very good -I'm not deficient in vitamins etc....like you can get if you can't absorb ANY fat. In fact, I would guess that I AM able to absorb all the fat I need, but the D is promoting some weightloss regardless - but past my Atkins goal still.

Doreen. How do you know all this stuff and explain it so well? You must be a nurse or a physician. I thank you, in tears as I sit here, for helping me understand (corny but true). I know that this is very loosely related to lowcarbing/but it is in a way. And I am certainly on THE RIGHT DIET - can you imagine how much trouble I would be having on a very low fat diet right now?? Wow.

So my diet will remain the same. I will go through extensive testing this month and they will probably tell me that I have too much bile and put me on questran. I will probably use it at times when there isn't alot of fat around to eat or if I get the D too much.

I KNOW THIS must have helped someone...because it helped me.
Thanks again.
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  #9   ^
Old Thu, May-16-02, 12:02
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nsmith4366 nsmith4366 is offline
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Doreen,

I am now on Questran light (prevalite). I continue my low carb diet - normal (not obscene) amounts of fat. I am now off metamucil (yikes) at the request of my speciallist.

My question is, if questran absorbs bile in my system, and bile makes use of fat - Does this mean that my body will digest and use LESS --or NONE of -- fat that I eat?

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

Would not digesting fats well on questran = constipation in a person with no gallbladder ? (it is a common side effect of questran in people with gallbladders) - I normally had D - could it be that this questran constipates me just enough to make bowel movements normal again? Should I eat much more fat than before to avoid further weightloss or just keep the same amount of fat per meal??

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. N
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  #10   ^
Old Thu, Sep-19-02, 09:58
LBDropper LBDropper is offline
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Default

Remeber you should only be using Questran or Colestid IF you had your gallbladder out. As for Darvocet it DOES NOT bind bile it just makes you constipated like all pain relieveres can. So darvocet is like taking immodium just a lot more dangerous. All Questran and Colestid will do is help you turn back into a normal person. After having D long enough your body gets used to it and you will not lose weight. I take 1 g in the morning 1 g at night of Colestid. If it's too little you take it in the morning only if then still too much take it every other morning, if it's too little you call your doctor and he can adjust it to more. If some people see having D all the time as a good weight loss well it's not because having it all the time like that you aren't getting nutrients you need and you don't think as well. Also if you a lot and bad foods and you don't gain because of the D your body will get used to it sooner or later and you will begin to pack on the pounds. So don't depend on the D.
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  #11   ^
Old Thu, Apr-07-11, 21:19
grammie2 grammie2 is offline
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Hello,
I just found this site and think it is great! I have just been diagnosed after years (since 1992) of a long road and oodles of tests and repeated tests with Bile Salt Diarrhea. I am 61. When I went to the Gastro doc today, I asked him do you suppose BSD? He said, yes that is what I was going to tell you. I had been doing some research on it. Being an nurse, I always research stuff. Anyway, I told him about reading that taking Calcium Carbonate 600mgs-1200mgs can help stop D. So in the weeks waiting for my appt. I started the Calcium (make sure it is Carbonate) 1 in the AM with my 10mgs Bentyl (dicyclomine) and again at supper. If I do indulge in to much fat or fresh fruits & veggies and the sudden D starts anyway, I go ahead and take another 600mgs. If the D is not stopping after an hour, I will take another 600mgs and Bentyl. If it is a real bad flare, I will take Imodium or Lotmotil (this is by prescription). He said the calcium and vit. D 2000 Units a day is great since BSD causes malabsoprtion of fat soluable vit. and calcium. I gave him the info. He also gave me the antibiotic Xifaxan for small bowel bacterial over growth and Questran. Not sure about the Questran if I can moderate my indulgence in fats and food triggers. I would rather do it natural.

I have compensated by eating so much carbs like bagles, toast, crackers, cereal all the time as I am hungry. I need to loose about 34 pounds although with RSD/CRPS one of the meds I am on causes wt. gain or really affects loosing wt. So am going to explore this site.

Any input is really appreciated to help me get the right balance of carbs and protiens. I do not get enough protein. Thank you,
grammie2
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  #12   ^
Old Fri, Apr-08-11, 23:26
grammie2 grammie2 is offline
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Plan: I need to find one
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Default More info on me and think I may have chosen the right plan

Hello,

Last night I was looking at all the low carb diets. I hope if someone has input on all of this, I will really appreciat it.

First when I got home late this evening, my family doc and left a message that my blood sugar is up. A new thing for me but no wonder when all the foods I eat are to keep from having D. Now that one at a time, I am being stared on Xiafaxin antibiotic just for the "gut". I am allergic to so much but since this does not leave the gut, praying it will work. I will be on an adjustable dose of Questran powder.

So since I love 1% milk, must watch the fat, fresh fruits and veggies I am going with the Insulin Resistance Diet for the low carb plan. My problem..Due to the systemic RSD, hernited disc and degenerative disease and even OP and PT wil flaer the RSD for tendonitis or bursitis. my mobility is limited.

Does anyone know about Tie Chia (SP?)? Does it help so that you can then be able to move up to more acitivity? I have many times tried, water (spa) excersis at PT. Same thing happens.
I aplolgize for well venting but am so new to low carb, feel a bit overhwlemed and would welcome any input.

Thank you so much and gain, I very very pleased with this site!
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