I wouldn’t suggest mixing cholestyramine with anything you’re hoping to absorb. It is very effective at binding with all sorts of things, and should be well separated from any medication. I’m assuming that you’ve already tried psyllium fiber, which is the usual go-to for bulking up stool.

Thanks Scott. I take lots of psyllium and, as I say, I'm often ok. Until I'm not. I wish I could see a reason.

I mix a probiotic powder and d manose powder (a cranberry derivative to help prevent UTIs) in yogurt . Are you saying that  not only should I not add the cholestyramine to the yogurt but actually take them a few hours apart?

I would like to add to Scott’s recommendation in that be very careful in dosing this medication. I was given this drug at one of my hospital stays and it constipated me for 2 days. I would start with a smaller dose to check your tolerance for it.

That's good information also.  I think I'll start with 1/4 of the dose before bed. Wish me luck!

Good luck, and please let us know your outcome, because I have a supply of this and I would to try it again, but I am a little leery of it.

I can’t speak to the value of d-mannose for UTIs, though it can cause diarrhea. Yes, if you want it to end up in your body instead of in the toilet it’s probably best to take it a couple of hours away from a cholestyramine dose.

My doc used to prescribe that powder as well (but now they have it in pill form as an FYI). He told me it’s fine to put it in things like apple sauce and stuff. I usually defer to what he suggests. He did say that you have to be careful taking it close to when you take other medications, however, as it doesn’t absorb as well if you do that.

i take it in pill form, in addition to loperamide and it helps a lot. Best of luck!

Thought I'd provide an update. I used the cholestryamine for two weeks without any success at all. The surgeon's second suggestion was Lomatil which I've been using with great success for the past month or so. Success in that the stool consistency is such that I am not having much leakage through the r/v fistula. I'm not sure it's sustainable though,  as it's $87 per month and although my doctor was able to get an exception and provinical pharmacare will cover it, it doesn't kick in until I've reached my over $3000 deductable.

I'm considering trying increased does of loperamide instead which, I think, is somewhat cheaper athough definitely not covered by provinicial or private drug coverage. Any thoughts on Lomatil vs Immodium? Thanks.

Funny you should ask!

I recently up my dose to 4 loperamide per day.

breakfast, before dinner, after dinner, bedtime.

adding the dose after dinner has now given me almost perfect pouch function.

be careful, I have found that taking two doses at the same time, amplifiers the effect and constipates me. By taking the doses separately allows for the proper slowing down without undesirable side effects.

I have not taken lomatil recently, so I can’t speak to its efficacy regarding pouch function.

good luck!

I take Lomotil at bedtime daily. Here in the US it seems to be an inexpensive medication, at least as well as I can determine with insurance. I was surprised to see it’s expensive anywhere, since medications are usually most expensive in the US. Perhaps the generic form (diphenoxylate/atropine) might be less pricey?

It is the generic form that I've been prescribed. I thought perhaps I could order from an American online pharmacy. I only looked at one but saw the cost for 90 tablets (close to a  month's worth) is $60 US which equates to $80 Canadian. I should likely try to see if increased loperamide (about $50 Cnd) works similarly. It's tough, though, because I've not had a major 'fistula day' since I started the Lomitil.

Some of us can be pretty confident that we’ll meet our deductible by the end of the year. If that applies to you then it may often be irrelevant what you spend that deductible on. Individual items can feel expensive, but at the end of the year it’s the same deductible expense.

I won't come anywhere near my family deductible but I guess I'm grateful that my husband and I don't require much medication. I'll try Imodium but if it doesn't provide at similar effectiveness I'll have to figure out how to stay on the Lomotil. The fistula was reaching the point where I was needing to think about an ostomy.

Thanks for your input on this.

My health insurance has an individual deductible that's half of the family deductible. All I have to do is meet that to change the economics drastically. I hope you're able to get the medication that works best for you.

Chloestyramine should be taken 1 hour after medicines medicines.

After you take cholestyramine- wait 4 hours until taking any medicines.