How can I convince a doctor to give me Cholestyramine?

[IsthmusSIBO]

So I suspect I have BAM caused by dysbiosis in the terminal ileum (now causing dysbiosis everywhere).

The issue is finding a doctor that will give me a CSM script. My country already has an issue with shortages of this drug, so that may be a role in their hesitation (but none actually say it, so maybe not).

Instead of giving me a script to just try it, they all want me to go into antibiotics first. Obviously this is not something anyone should do. And I am already stable if I don’t eat fat or sulfur foods.

Does anyone have suggestions on traits to identify a doctor that maybe more open to try this is a first line therapy instead? And if not, what type of things can I tell them aside from my OBVIOUS medical history?

 

[Michael Harrop]

Maybe a younger doctor. You could bring some medical literature covering BAM, and let them know you've verified the issue by eliminating fat from your diet. You could also bring studies on antibiotic harms.

 

[IsthmusSIBO]

Maybe a younger doctor. You could bring some medical literature covering BAM, and let them know you've verified the issue by eliminating fat from your diet. You could also bring studies on antibiotic harms.

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Oh man, I just came from an appointment with a neuroGI that looks around 30ish, he told me he would rather treat SIBO (made the mistake of being honest and telling him) first and then give me CSM if it recurs.

At least he is already familiar with BAM without surgery being misdiagnosed as IBS. Shame he wants me to try the SIBO treatment first.

 

[Michael Harrop]

Direct him to the SIBO wiki page, especially this: https://forum.humanmicrobiome.info/threads/critical-appraisal-of-the-sibo-hypothesis-and-breath-testing-a-clinica.408/

 

[IsthmusSIBO]

Direct him to the SIBO wiki page, especially this: https://forum.humanmicrobiome.info/threads/critical-appraisal-of-the-sibo-hypothesis-and-breath-testing-a-clinica.408/

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Thanks Michael. His secretary is pretty trash so I will move on from him anyways. I will make sure to be more prepared next time I see a doctor.

 

[SFBayFMT5]

Keep in mind that cholestyramine is a stopgap, likely not a permanent solution. Also many formulations of it are loaded with sugar because apparently some people hate the experience of essentially drinking plastic granules, and we know that sugar can feed dysbiotic microbes. In fact when I didn't have C. diff taking cholestyramine actually made me worse because of all the added sugar. When I did have C. diff, the toxin binding won over the sugar... barely... and I felt a bit better.

 

[IsthmusSIBO]

Keep in mind that cholestyramine is a stopgap, likely not a permanent solution. Also many formulations of it are loaded with sugar because apparently some people hate the experience of essentially drinking plastic granules, and we know that sugar can feed dysbiotic microbes. In fact when I didn't have C. diff taking cholestyramine actually made me worse because of all the added sugar. When I did have C. diff, the toxin binding won over the sugar... barely... and I felt a bit better.

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Thanks for your experience. I am still doing tests for parasites and things like that to discare hidden infections, so we will see. I just rather try it to see if it helps.

I don’t think my version of it will have sugar to be honest. Its only sold by the government and hospitals in here, so I think it will be pretty barebones.

I do envy people in English speaking countries when it comes to BAM, because they can try Colesevelam if CSM is too much for them.