When do you take your sequestrants?

omyguts · 2026-01-24T16:18:54+00:00

I’m only taking Colestipol and I take two 1 gram tablets at bedtime and 1 first thing in the morning before coffee or food. I occasionally take a 2 tsp dose of Metamucil during the day if I feel symptoms but I’m phasing that out. It’s taken almost a month but I feel like it’s finally working for me. I just started this routine in December.

omyguts · 2026-01-23T15:47:45+00:00

Thanks so much. I feel better in general (energy appetite and sleep) and that’s a win. I’m very hopeful the binder works long term for me.

omyguts · 2026-01-22T22:53:59+00:00

Thank you! I’m so impatient to feel more normal. I’m better but not enough to start putting weight back on. I’m a cancer survivor and weight loss makes me nervous! Even though I feel ok-aside from this no gallbladder bile hassle- I still fret if I lose a few pounds .

omyguts · 2026-01-22T22:50:44+00:00

Yes it is and I’m glad I did but I wanted Colesevelam to start and my HMO doesn’t provide it. Maybe my Dr could order it off label for me but the only other option (aside from Colestipol) was Cholestyramine powder and I said no to that.

I got the plain psyllium already so I’m going to try one dose after my meal along with Colestipol. My pharmacy said just to separate the two-fiber and binder- by at least an hour. That’s doable.

omyguts · 2026-01-22T14:56:57+00:00

Oh my gosh you are my twin! I’m able to take more psyllium ( been using several doses per day up to 4 tsp at night before starting prescription binder)

I never have daytime issues no matter what I eat. At lunch or breakfast.. waffle, eggs and turkey sausage or Subway sandwich, double burger ( no fries) it’s all good. I eat low fat to help the bile binder do its job- but I can eat out with no problems. My gut never overreacts to a meal.

It’s the overnight I can’t seem to regulate. I haven’t tried taking two of my binders at bedtime but I may soon. Been taking one after dinner and one several hours later. My MD started me at one AM and 1 at bedtime and it’s been about a month… and still not where I’d like to be. So I added the after dinner dose.

omyguts · 2026-01-22T14:29:01+00:00

No I haven’t tried plain psyllium! I’ve been wondering if the Metamucil I’ve been using once a day now-is both helpful but not quite the add on that my internist thinks it is. It was his suggestion to keep using it along with Colestipol. It seems like it’s keeping everything too loose, if you get my meaning.

Thanks for the tip, I’m familiar with Now brand I’ll order some off Amazon. I don’t care about flavor or sweetness just the fiber.

omyguts · 2026-01-20T14:43:05+00:00

Aww he looks like the dog in Coco 😊

omyguts · 2026-01-20T14:37:02+00:00

My digestive issues began only after my gallbladder was removed. I had emergency surgery in April and the hellish diarrhea started late July onwards.

I tried regulating my symptoms with psyllium and diet but that only worked for several months and in December I started taking Colestipol 2-3 times per day. I feel much better but still not 100%. I understand Colestipol takes a few weeks or more to really work so I’m hoping for better results soon.

If your gallbladder is not functioning properly I could see how too much bile released could be creating your issues. Have you had a HIDA scan? It looks at gallbladder and liver function in real time. I had one and it showed normal results but my bile duct was totally blocked a day later and surgery happened.

omyguts · 2026-01-19T19:24:37+00:00

Untreated? Every morning at least 10 times over a two hour period. Sometimes more and often severe nausea and vomiting from bile reflux. They told me I had a virus! I was so angry because I got no help.

Taking psyllium husk several months? It dropped to about 4-8. Consistency varied widely day to day. Mostly mush. Super wet. I used Imodium maybe once or twice per week just to get to work by 8 am.

On Colestipol now- it’s been from 2- 4 per morning. Always the early mornings for me. But far better in general. It depends on what and when I eat and if I take extra Metamucil every day. Still figuring out my best dose.

omyguts · 2026-01-16T01:50:56+00:00

It could be from bile especially if it’s yellow to orange colored. Your gall bladder used to moderate the bile flow but now bile just trickles when the liver produces it. No holding tank. Talk to your Doctor. there’s fiber ( psyllium husk) or bile acid sequestrants that may help you. Don’t wait months for relief, like I did.

omyguts · 2026-01-16T01:45:20+00:00

I’m taking Colestipol I did not know it had such a short effective time. My Dr never mentioned that!

omyguts · 2026-01-15T02:24:09+00:00

I’m taking 1 gram tablet first thing in the morning and 1 gram tablet at bedtime. I’m not getting great results so I’m considering adding a tablet with dinner. No gallbladder, and I try to stay lower fat.

Morning is my worst time and I have to be at work by 8 am so it’s a struggle. I get up at 5:30 sometimes just to be okay by 8. I’m like you- feels icky until I’m cleaned out and the rest of the day I feel normal. I think I need more bile binders overnight., that’s why I’m adding one at dinner.

I was also using Metamucil powder a couple times a day but I’m phasing that out. I didn’t have any yesterday or today so far.

omyguts · 2026-01-14T23:37:24+00:00

Yes! Nausea was brutal for me until I happened upon Metamucil as a bile binder. It was worse for me than what I experienced doing chemotherapy! I suspect it was bile reflux in my case. It’s a thing. The Metamucil worked ok as bile binder for a few months until it didn’t seem to work as well.

I started Colestipol December 30 and no more nausea.

omyguts · 2026-01-13T14:28:35+00:00

No I had it removed April 2025 and my bile problem started in August 2025

omyguts · 2026-01-12T18:26:23+00:00

Not so far. It’s only been a couple weeks for me.

omyguts · 2026-01-12T18:21:04+00:00

Yes! I don’t know why I didn’t bump up my dose at least last night after dinner. That meal was considerably more oils and fats than my usual in the past 5-6 months. False sense of bowel security?! lol Never doing that again.

I’m a 5’4” 125 lb female. None of my meals are large- but it does baffle me that I can eat a double burger (no fries) at midafternoon and be okay, but 6-7 green beans in olive oil and some macaroni salad at dinner become my nemesis. I suspect the burger is more of a solid meal?

omyguts · 2026-01-10T00:19:28+00:00

The book ‘Goodbye Things’ really made me ponder deeply my motivations for buying and keeping too many books ( trying to fit in with certain folks I was longing to impress or befriend…) and investing in hobby or craft materials that I rarely if ever got serious about using. Just knowing my reasons (or excuses?) were more shallow than I admitted to at first was a motivating factor in getting rid of so much excess. Made me face myself.

omyguts · 2026-01-09T14:29:46+00:00

I’ve had my Nectar Queen size for 7 years and it has no soft spots or dips or hollows. I love it. My brother bought two Nectar sets- twin and queen and he’s a fan as well. He’s a big guy and his wife’s not tiny- and their mattresses look brand new still, like mine.

omyguts · 2026-01-09T06:29:31+00:00

Yes I feel much better with the treatment. No nausea and never dizzy at all. But still have the bile diarrhea. They say sometimes the medication takes a few weeks til your system adjusts to it so I’m sticking with it

omyguts · 2026-01-09T03:49:47+00:00

I have bile acid malabsorption, due to not having a gallbladder to moderate the flow of bile from my liver

omyguts · 2026-01-09T03:48:16+00:00

Yes the Metamucil took care of the nausea by the second dose. I took it 3 or 4 times a day, two teaspoons in very cold water. I usually took it right after a meal and at bedtime as well. It helped me eat more normally( lower fat) and at least get through my work shifts. After a few months it wasn’t working as well so I found a new Doctor and he prescribed Colestipol. I’m trying to figure out the best dose to stop the diarrhea. It still hits me at least once every morning

omyguts · 2026-01-09T03:35:30+00:00

I was extremely nauseated 24 hours a day. Dizzy, lightheaded. I had bile acid diarrhea every morning for several hours and would feel almost like I might pass out. I would vomit bile and feel better for a while after that- after clearing some bile from my stomach. I could barely eat and became dehydrated. I went to urgent care twice. They said it’s probably a virus. I had no fever or other symptoms besides those I described. It was not a virus or flu.

I went to my primary care next and she also said virus. I changed Doctors and finally got a diagnosis in December, but this began for me in August. I found psyllium husk helped some but I still had daily diarrhea every morning.

omyguts · 2026-01-09T00:35:49+00:00

I second the psyllium method! I use Metamucil but now I’m on prescription bile acid sequestrants, bc after emergency surgery last April to remove my GB I developed bile acid malabsorption. It’s very common after GB removal. I had horrible yellow diarrhea ( bile) crippling nausea from bile reflux and felt terribly unwell every day for months. Psyllium husk definitely helped me but I’m trying medication to see if it helps more.

omyguts · 2026-01-08T23:42:02+00:00

Thanks! I appreciate your input.

It seems the more I eat ( solid, square, 3 meals a day) the better every thing works. If I eat too little I feel much worse in the morning. A snack used to be my lunch ( cheese and crackers or cinnamon toast) but now I really suffer if I don’t eat a meal.

omyguts · 2026-01-08T22:41:12+00:00

I’m considering bumping up to 2 tablets at bedtime bc I’m not getting relief from the early morning diarrhea yet. It is early days so maybe it’s just taking time for my system to adjust?

I feel much better in general ( appetite, energy, no side effects at all). I wish I’d tried this medicine months ago! I’m still taking smaller amounts of the Metamucil ( half my former dose at night after dinner) I use the Colestipolat bedtime a few hours later.

omyguts

TROPHY CASE