Questran, Welchol, and Psyllium Husk for Crohn's Disease - A Warning

[David]

I occasionally see people on here who are taking either Questran or Welchol. These are drugs that are occasionally prescribed off-label for Crohnies because they sequester your bile acid. What's that mean? It means you poop less. Great, huh? Well, the problem here is that these medications are prescribed for people with high cholesterol. They work great for lowering cholesterol but in the process, inhibit the absorption of vitamins A, D, E, and K as they are fat soluble vitamins. If you're a Crohnie, this is the absolute opposite of what you need.

If you absolutely must be on one of these meds (I'd suggest discussing taking psyllium husks with your doctor instead *edit* - note Dustykat's information below that psyllium can also have an affect on absorption, argh!) then, for the love of all that is holy, please supplement those vitamins and take the supplements at least 4 hours prior to taking your Welchol or Questran. And also read up on the negative interactions of vitamin A and D here so you handle that properly as well.

 

[Emily]

Good to know David, thanks. Been on/off Welchol for a while, and back on once more at a low dose. It also inhibits other stuff especially like birth control pills, so the same goes for those, be sure to take them at least 4 hours beforehand! Don't wanna mess that up!

 

[DustyKat]

Hey David,

I'm not sure if I am reading you correctly so please disregard the following if I am. ...

Are you speaking only of the supplementation of the fat soluble vitamins being inhibited by Questran or their absorption generally?
For those with extensive ileal disease and/or ileal resection, the absorption of the fat soluble vitamins are already inhibited.

Now regard again. ...

I certainly agree that Questran does inhibit the absorption of vitamin A, D, E & K and any supplementation of them and any prescription medication should be given at the time frames you have listed BUT psyllium also has a similar effect on the fat soluble vitamins and prescription medications. These are the instructions the GI gave us...

prescription drugs/supplements should be taken 1 hour before or 2-4 hours after psyllium

The only thing I can say is thank you for bringing this up David, I have been very remiss for not mentioning it earlier.

Dusty. :heart:

 

[David]

Are you speaking only of the supplementation of the fat soluble vitamins being inhibited by Questran or their absorption generally?

I was speaking of their inhibition by Questran and Welchol.

For those with extensive ileal disease and/or ileal resection, the absorption of the fat soluble vitamins are already inhibited.

Thanks for bringing that up

psyllium also has a similar effect on the fat soluble vitamins and prescription medications. These are the instructions the GI gave us...

prescription drugs/supplements should be taken 1 hour before or 2-4 hours after psyllium

Well, dammit. I'll add psyllium to the warning as well. Thanks for saving the day Dustykat :heart:

 

[CyCrohn'sGuy]

Have been using psyllium for a couple of weeks and although the results were amazing I noticed that my legs started to swell a couple of days ago, plus I was experiencing chest pains, nausea and panic. I researched online and found a site advising against the use of Psyllium Husks with Warfarin (blood thinners) which I have been on for just over a year since having a blood clot in my right lung following my resection.

I had a blood test this morning and my INR has dropped to 1.77 which is dangerously low apparently. My GI has increased my intake of Warfarin to 10mg per day until the INR balances out (2.5 is normal for me). I am also wearing these very attractive thrombosis socks for the next few days to reduce the swelling.

Damn, back to square one!!!!

Costas

 

[Crohn's 35]

I havent been on Questran for years, but after my removal of my second resection and gall bladder, pure bile and bms 15 times a day. Now somehow I have managed to have maybe 4bm and rarely have D. I eat oatmeal everyday to slow it down, naturally. I did know when I was on Cipro and Questran it was hell trying to take stuff at different times, I never took anything at the same time as Questran. Because we lose alot more nutrients through D we really have to listen to our bodies... mine needs to lose weight :lol:. Good that you brought this up.

 

[chrisnsteph1022]

I just started psyllium husks a couple weeks ago and take it with all my other drugs (except imuran-that one's at night). I guess I need to start separating that one out.

 

[Silvermoon]

Yes, this is a tough one....

For some of us who have had two (or more) resections, SOMETHING is needed to slow down the elimination of waste, as if food/supplements are just passing straight through, that doesn't really help the matters either, so sometimes you are stuck in a 'damned if you do; damned if you don't' situation.

As mentioned, with ANY of the motility-altering "medications" (whether it is fiber or perscribed meds) just remember to take them 2 to 4 hours before or after (preferably before - although sometimes you have to adjust your schedule according to what is best for you) around your other medications.

Great info, guys!!

 

[Miss Underestimated]

At least 4 hours apart is right, that's what I was told. and the Bile acid sequestrants work best if you take them about 15 minutes before you eat. I changed to this and it makes a difference in the effectiveness.

Now I just have to remember it.

David, my doctor said there are some theories being tested now, that the vitamin D deficiency may be a cause of IBD in some people. I've been looking for the test.

I know they are doing trials to see if it prevents cancer - I was invited to participate, but they didn't know I'm a Crohnie.

 

[David]

David, my doctor said there are some theories being tested now, that the vitamin D deficiency may be a cause of IBD in some people. I've been looking for the test.

In email correspondence with the MD in charge of the Vitamin D Council, he feels proper supplementation of Vitamin D will CURE (he used the word cure) some with Crohn's Disease or other forms of IBD.