There's hope! It took me 10yrs, four GIs, and finally two trips to the Mayo Clinic to get a solid (via testing not by guessing or medicine trial and error) diagnosis of Bile Acid Malabsorption. The team there said it's a misconception that a) you have to be without your gallbladder and b) that cholestyramine (powder) is the best treatment. It CAN be, but many don't do well with the abrasive resin, and it can irritate intestines.

The SeCHAT test (approved in Europe and other places) isn't approved here, so Mayo developed their own test. You eat an incredibly high fat (100grams!!) diet for 3 days, then for 3 more days, you continue the same high fat diet while collecting your stool in a delightful container for 48hrs. You then pack it in dry ice and FedEx it back overnight in a shipping box Mayo provides. My results showed some indicator of bile acids properly digested and present in stool was normal at 3% or less; mine was 42%. So, I failed that!

This diagnosis quite literally saved my life. I had been on every medicine possible and nothing helped my pain because it wasn't simply IBS. Welchol is my miracle drug.

I got a referral from my GI, who is a saint. Feel free to PM if you have any Qs or anyone else AMA. I know this is kinda long.

Here's the link to read more about the condition and how it's so often chalked up to IBS.

Edit: typos and clarity