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I don't have my pouch yet but I took cholestyramine during my UC flare. If the terminal ileum is inflamed (I had backwash ileitis) or otherwise not absorbing bile as it should cholestyramine binds to bile acids so they don't cause diarrhea when they pass into the colon. I had bright yellow, burning diarrhea during my UC flare and the cholestyramine reduced it. I took two packets per day, mixed with water. It's also available in a pill form (called Questran I believe) but I never tried that. I'm guessing the result for someone with a pouch would be similar.

You do have to be really careful with it though because it can interfere with absorption of medication and nutrition. The label says something crazy like not to take any other medications two hours before or six hours after, my GI always said an hour in either direction was OK.
P
Used it for bad butt burn when I first had my J-Pouch,which was created 28 years ago. I found it quite helpful, altho unpleasant to consume (then it was a powder to mix with water, dont know how it is formulated now). After a few months I didnt need it anymore and now occasionally I just use A&D ointment altho I hardly ever get BB and havent for many many years. Try it... it did wonders for me.
H
Cholestyramine is very helpful in firming stool and binding acids against butt burn. You just need to figure out a rhythm to make it compatible with whatever else you are taking.
I take 2 immodiums in the morning and 2 4 hours later. I take the cholestyramine about 5 or 6 hours after that. It has also helped me to cut my immodium intake in half.
My GI told me that large doses per day (2-3 times)can interfere with the absorption of fat-soluble vitamins. That's why I stick with one in the evening, and that does do the trick with stool-firming throughout the night and into the next morning.
I don't have a problem with taking the powder, although I can imagine some people won't like it. I mix one pouch with water and down the hatch. I mix in more water and dissolve the clumps in the glass, and drink that.
There are lists online of which medications it will interfere with. If you can manage with one dose per day then it's not difficult to manage.
S

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