cholestyramine / Generic mfg. - LARVOL DELTA

PFAS Clinical Trial (clinicaltrials.gov) - P2 | N=300 | Not yet recruiting | Sponsor: Emory University

New P2 trial

Delayed Diagnosis of Crohnâs Disease Following Ileal Pouch-Anal Anastomosis: A Diagnostic Challenge (ACG 2026) - "Colonoscopy confirmed severe colitis, and he was started on 6-mercaptopurine with good response. In 2016, elevated liver enzymes and worsening psoriasis prompted transition to adalimumab, which was discontinued after suspected drug-induced lupus...With infliximab and methotrexate initiation, he achieved clinical and endoscopic quiescence...Post-operative diarrhea and bowel urgency were unresponsive to ciprofloxacin, loperamide, cholestyramine, and dicyclomine...He remains on vedolizumab for luminal disease and risankizumab for psoriasis with sustained remission...In our case, delayed recognition contributed to a complicated clinical course, including bacterial infection, pouch-related complications, and poorer quality of life. Hence, this case highlights the importance of maintaining diagnostic flexibility at the onset of suspected IBD and the need for prudent treatment reassessment in refractory or atypical disease courses."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Psoriasis • Ulcerative Colitis

Adjunct Cholestyramine Accelerated Thyroid Hormone Reduction in Refractory Hyperthyroidism: A Systematic Review (ATA 2026) - No abstract available

Review • Endocrine Disorders

Fulminant Thyroid Storm with Severe Hepatic Failure Managed without Thionamides: A Multimodal Strategy Incorporating Plasmapheresis, Lithium, Cholestyramine, and Dexamethasone (ATA 2026) - No abstract available

Hepatology • Liver Failure

Profiles of nonsteroidal anti-inflammatory drug-induced gastric antral ulcers: A comprehensive review of the preclinical data. (PubMed, J Pharmacol Exp Ther) - "Dietary supplementation with taurocholate aggravated indomethacin-induced AUs, whereas cholestyramine, a bile acid sequestrant, attenuated them. SIGNIFICANCE STATEMENT: Nonsteroidal anti-inflammatory drug-induced gastric ulcers are induced dependently on feeding conditions, dietary fibers, intragastric bile acids, gastric motility, and stress. This review summarizes the recent advances and provides new insights into the pathogenesis of nonsteroidal anti-inflammatory drug-induced foregut mucosal injury and may contribute to novel and effective pharmacological approaches for ulcer prevention in humans."

Journal • Preclinical • Review • Gastrointestinal Disorder • Peptic Ulcer • HRH2

Thyroid Storm Presenting With Refractory Atrial Arrhythmia and Tachycardia-Induced Dilated Cardiomyopathy: A Case Report. (PubMed, Cureus) - "Multiple rhythm-control and rate-control strategies were required, including direct-current cardioversion, adenosine, magnesium, digoxin, beta-blockers and escalating infusions. Amiodarone was discontinued following multidisciplinary review due to concerns regarding iodine-induced exacerbation of thyrotoxicosis. Thyroid storm was treated with propylthiouracil, Lugol's iodine, hydrocortisone, propranolol and cholestyramine. Serial echocardiography demonstrated interval improvement in left ventricular systolic function, supporting a reversible tachycardia-mediated mechanism. This case highlights the diagnostic and therapeutic complexity of thyroid storm with refractory arrhythmia and underscores the importance of early recognition, multidisciplinary management and careful selection of antiarrhythmic therapy."

Journal • Cardiomyopathy • Cardiovascular • Cognitive Disorders • Congestive Heart Failure • Endocrine Disorders • Grave’s Disease • Heart Failure • Hypertension • Metabolic Disorders • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Possible Unmasking of Early Crohnâs Disease After IL-17 Inhibition (ACG 2026) - "Her HS had been treated with adalimumab from 2020-2022 and infliximab from 2023-2025 before switching to bimekizumab-bkzx. She had intermittent diarrhea previously attributed to irritable bowel syndrome (IBS) and post-cholecystectomy bile acid diarrhea treated with cholestyramine...However, this case highlights the importance of distinguishing functional diarrhea from inflammatory diarrhea in patients receiving IL-17 inhibitors. Inflammatory biomarker testing may guide further evaluation and reassessment of IL-17 therapy when confirmed intestinal inflammation develops."

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hidradenitis Suppurativa • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • IL17A

Methimazole-Induced Agranulocytosis: A Case Report (ETA 2026) - "Treatment was initiated with piperacillin/tazobactam, filgrastim, and propylthiouracil (PTU) 200 mg every 8h, and methimazole was discontinued...PTU was discontinued, and propranolol 10 mg every 8h, hydrocortisone 100 mg every 8h, and cholestyramine 4 g every 8h were initiated... Routine monitoring of leukocyte counts is not recommended, as agranulocytosis occurs abruptly. Given its potential severity, it is essential to inform patients about warning signs and symptoms at the initiation of treatment with thionamides."

Case report • Clinical • Agranulocytosis • Dysphonia • Endocrine Disorders • Febrile Neutropenia • Gastrointestinal Disorder • Granulocytopenia • Grave’s Disease • Hematological Disorders • Infectious Disease • Leukopenia • Mood Disorders • Neutropenia • Otorhinolaryngology

Carbimazole resistant Graves' disease: A case report. (ETA 2026) - "Adjunctive therapy including beta-blockers, dexamethasone, and cholestyramine provided minimal biochemical improvement...The patient was subsequently switched to propylthiouracil (200 mg twice daily), with only partial biochemical response. Given persistent thyrotoxicosis and the risk of long-term drug toxicity, definitive surgical management with total thyroidectomy was undertaken, following which the patient achieved biochemical remission and was maintained on levothyroxine replacement... This case highlights the importance of recognizing true ATD resistance after excluding non-adherence and malabsorption. Early consideration of definitive therapy, particularly thyroidectomy, can provide rapid and effective control of hyperthyroidism when medical therapy fails."

Case report • Clinical • Cardiovascular • Celiac Disease • Endocrine Disorders • Grave’s Disease • Immunology • Movement Disorders • Ophthalmology

Vanishing Bile Duct Syndrome Associated With Hodgkin's Lymphoma (ACG 2026) - "She was treated with corticosteroids, ursodiol, and cholestyramine...Over the course of her chemotherapy regimen of cyclophosphamide followed by doxorubicin, her liver enzymes subsequently normalized over several weeks, supporting HL as the main driver of her VBDS...World journal of gastroenterology , 23 (2), 366-372. https://doi.org/10.3748/wjg.v23.i2.366"

Celiac Disease • Cholestasis • Hematological Malignancies • Hepatology • Hodgkin Lymphoma • Immunology • Infectious Disease • Liver Failure • Lymphoma

Beyond cholesterol: regression of carotid plaques in an adolescent-a case report. (PubMed, Eur Heart J Case Rep) - "Following the identification of a paradoxical pro-atherogenic effect of a standard lipid-lowering diet, treatment with a plant-oil-restricted diet and cholestyramine resulted in a 51.7% reduction in carotid plaque thickness. This case highlights the necessity of screening for sitosterolaemia in paediatric patients with unexplained carotid plaque. Plaque resolution was achieved only after replacing conventional lipid-lowering strategies with targeted phytosterol-lowering interventions and specialized dietary modifications."

Journal • Atherosclerosis • Cardiovascular • Dyslipidemia • Pediatrics

Effect of Bile Acids on Daidzin Metabolism to Equol during In Vitro Incubation of Human Feces. (PubMed, J Nutr Sci Vitaminol (Tokyo)) - "Co-addition of cholestyramine attenuated the inhibitory effects of BAs; therefore, ingestion of substances with BA-binding ability was expected to improve Eq production. However, the addition of sodium alginate, which has BA-binding ability and may affect the microbiota, showed variable response among individual samples. These results strongly suggest that BAs secreted into the intestinal tract are significant factors affecting Eq production in humans."

Journal • Preclinical

CAR-Tastrophe in the Gut: Two Cases of Immune Effector Cell-Associated Enterocolitis (ACG 2026) - "Colonoscopy revealed edematous, erythematous, cobblestoned mucosa with loss of vascularity in the right colon involving the IC valve (Figure 1) and he was treated with vedolizumab in addition to IV steroids for concern of IEC-EC...CASE 2: A 74-year-old male with MM received CAR-T therapy (Carvykti)...Symptoms briefly improved with budesonide and cholestyramine, but later recurred...Ruxolitinib was associated with clinical improvement in both cases, suggesting it may be a promising treatment option. Figure: From Case 1: Mucosal edema, erythema, nodularity, cobblestoning, loss of vascularity, pale raised patches and ecchymosis seen in distal ascending colon and into cecum, involving the IC valve."

CAR T-Cell Therapy • Clinical • Febrile Neutropenia • Gastrointestinal Disorder • Hematological Malignancies • Multiple Myeloma

The Colitis Conundrum: Triple Pattern Severe Pancolitis With Discordant Infectious and Eosinophilic Features (ACG 2026) - "He was treated with fidaxomicin and high-dose oral vancomycin, along with octreotide, cholestyramine, dietary modification, and supportive care. Finally, this case underscores a practical treatment gap: lack of FMT availability necessitated prolonged high-dose antimicrobial therapy, with potential impact on recovery and resource use. Figure: Colonoscopy findings"

Discordant • Cardiovascular • Chronic Kidney Disease • Diabetes • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hypertension • Hypotension • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Renal Disease • Septic Shock • Type 2 Diabetes Mellitus

Severe Nirogacestat-Induced Colitis Responsive to Budesonide After Failure of Standard Therapies (ACG 2026) - "Despite treatment with cholestyramine, loperamide, dicyclomine, tincture of opium, octreotide, and high-dose hydrocortisone, diarrhea persisted at 3-5 L/day. Budesonide's potent local anti-inflammatory activity and limited systemic absorption may make it a valuable treatment option for inflammatory chemotherapy-related colitis, particularly when associated with targeted therapies. Further studies are needed to evaluate its efficacy in similar cases."

Desmoid Tumors • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Immunology • Sarcoma • Solid Tumor • CRP

Chronic Diarrhea Due to Occult VIPoma Without Pancreatic Mass (ACG 2026) - "Her symptoms were initially attributed to IBS-D but trials of chlordiazepoxide-clidinium, diphenoxylate and atropine, loperamide, rifaximin provided minimal relief...Pancreatic enzyme replacement, dietary modification, and cholestyramine were not effective...Figure: DOTATE PET scan image showing increased uptake in the right retroperitoneal soft tissue. Figure: Cryoablation of the retroperitoneal lesion under Computed tomography guidance."

Fibromyalgia • Gastroenterology • Gastrointestinal Disorder • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammatory Arthritis • Musculoskeletal Pain • Neuroendocrine Tumor • Psoriasis • Psoriatic Arthritis • Seronegative Spondyloarthropathies • Solid Tumor • ELANE • GAST

A Bitter Pill to Swallow: Histologic Mimics Among Ion-Exchange Resins in Esophageal Injury (ACG 2026) - "However, significant morphologic overlap exists among ion-exchange resins, including sodium polystyrene sulfonate (SPS) and cholestyramine, creating potential diagnostic challenges and risk for histologic misclassification...Careful correlation between clinicians and pathologists is critical to improving diagnostic accuracy and understanding the true contribution of these agents to upper gastrointestinal injury. Figure: Histology of esophageal biopsy in the second case showing sevelamer crystals Figure: EGD in the first case showing severe esophagitis with mild oozing and esophageal ulcers."

Diabetes • Diabetic Nephropathy • Gastrointestinal Disorder • Infectious Disease • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Type 1 Diabetes Mellitus

Fecal Microbiota Transplantation in Refractory Immune Checkpoint Inhibitor-Induced Colitis (ACG 2026) - "Current National Comprehensive Cancer Network (NCCN) guidelines reserve FMT for patients who have failed initial corticosteroids, biologics including infliximab or vedolizumab, and additional agents such as tofacitinib or ustekinumab, or in whom such agents are contraindicated. Case Description/ A 70-year-old woman with metastatic melanoma was initiated on pembrolizumab 200 mg every 3 weeks...Her diarrhea remained refractory despite four tapering courses of prednisone and three doses of vedolizumab...Cholestyramine was briefly used for transient soft stool but discontinued due to constipation...Unlike traditional donor-derived FMT sourced from stool biorepositories, fecal microbiota, live-jslm offers a standardized and commercially available formulation that simplifies procurement and administration...While recent NCCN guidelines position FMT as salvage therapy, emerging data suggest that a single dose of FMT may induce steroid-free remission in a significant proportion..."

Checkpoint inhibition • Constipation • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Melanoma • Oncology • Solid Tumor • Transplantation

Persistent Diarrhea and Orthostatic Hypotension; Uncovering the Impact of Diabetic Autonomic Neuropathy (ACG 2026) - "Gastroenterology consultation initially recommended incorporating high-dose cholestyramine, scheduled l omotil, imodium, and empiric rifaximin for possible small intestine bacterial overgrowth...Her blood pressure remained labile despite volume repletion, prompting the initiation of midodrine & fludrocortisone for support...Furthermore, in this patient, first and second line therapies were ineffective and led to longstanding diarrhea with severe volume loss. Earlier initiation of octreotide may be warranted in similar patient populations."

Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Neuropathy • Hypotension • Metabolic Disorders • Renal Disease • GAST

Severe Hyperbilirubinemia in Gravesâ Thyrotoxicosis: A Therapeutic Dilemma in Cholestatic Liver Injury (ACG 2026) - "Severe hyperbilirubinemia creates a dilemma because antithyroid drugs, especially propylthiouracil (PTU), can cause hepatotoxicity...Despite hyperbilirubinemia, PTU was started with prednisone, cholestyramine, and close monitoring due to concern that thyrotoxicosis was perpetuating cholestatic liver injury...Figure: Figure 1. Liver Chemistry Improvement After PTU-Based Therapy"

Autoimmune Hepatitis • Cardiovascular • Cholestasis • Endocrine Disorders • Grave’s Disease • Hematological Malignancies • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Multiple Myeloma • Portal Hypertension • Respiratory Diseases • Smoldering Multiple Myeloma

When "Natural" Turns Toxic: Plasmapheresis Rescue in Ashwagandha-Induced Cholestatic Liver Injury With Bile-Cast Nephropathy and Refractory Pruritus (ACG 2026) - "Pruritus was refractory to cholestyramine, rifampin, and antihistamines...He received IV methylprednisolone transitioned to oral prednisone...This case supports plasmapheresis in select patients with severe cholestasis or bile-acid-mediated complications when standard therapies fail. Figure: Trend of total bilirubin (red), anion gap (orange), CO2 (green), and chloride (blue) over time, demonstrating progressive cholestasis with rising bilirubin and metabolic derangements followed by rapid biochemical improvement after initiation of plasmapheresis (June 2025)."

Acute Kidney Injury • Addiction (Opioid and Alcohol) • Cholestasis • CNS Disorders • Dermatology • Hepatology • Immunology • Liver Failure • Metabolic Disorders • Nephrology • Pruritus • Renal Disease • Steven-Johnson Syndrome

When Colon Biopsies Mislead: Refractory Diarrhea as a Manifestation of GI ATTRv Amyloidosis After Heart and Liver Transplantation (ACG 2026) - "Case Description/ A 71-year-old male with hereditary ATTR cardiac amyloidosis, status post liver and heart transplant (2016), on vutrisiran, presented with chronic refractory diarrhea...He failed loperamide, diphenoxylate, tincture of opium, codeine, antibiotics, cholestyramine, and fiber...Third, diarrhea in GI amyloidosis is multifactorial-including SIBO, malabsorption, protein-losing enteropathy, rapid transit, and autonomic neuropathy-and remains difficult to manage even after surgery. Figure: Figure 1 and 2 Figure: Figure 3"

Biopsy • Amyloidosis • Cardiac Amyloidosis • Cardiovascular • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Immunology • Transplantation

Anchored in Immunotherapy: Sevelamer/Cholestyramine-Induced Colitis Masquerading as ICI Colitis (ACG 2026) - "She required admission for intravenous steroids when diarrhea was refractory to oral prednisone. Clinically, this may prevent unnecessary immunosuppression and allow targeted treatment through medication discontinuation. Figure: Figure 1: Flexible Sigmoidoscopy performed with hemorrhagic ulcerated mucosa in the sigmoid colon (A-C) and rectum (D)."

Cervical Cancer • Gastroenterology • Gastrointestinal Disorder • Immunology • Solid Tumor

Acute Liver Failure in Thyroid Storm: A Multifactorial Hepatic Injury in the Setting of Gravesâ Disease and Cardiogenic Shock (ACG 2026) - "Thyroid storm was diagnosed clinically, and treatment with methimazole, beta-blockade, glucocorticoids, and cholestyramine was initiated...She was managed supportively, including N-acetylcysteine...Thyroid storm should be considered in patients with unexplained ALF and cardiovascular instability, as early recognition and multidisciplinary management may improve outcomes even in severe multisystem disease. Figure: Timeline of Clinical Events"

Cardiovascular • Chronic Kidney Disease • CNS Disorders • Congestive Heart Failure • Coronary Artery Disease • Endocrine Disorders • Grave’s Disease • Heart Failure • Hepatic Encephalopathy • Hepatology • Inflammation • Liver Failure • Myocardial Infarction • Renal Disease

Clinical Profile, Response to Therapy, and Outcome of Progressive Familial Intrahepatic Cholestasis in Children: A Developing World, Single-Center Experience (ACG 2026) - "All cases got medical therapy including combination of antipruritic agents (UDCA, rifampicin and cholestyramine), and 16 (21.3%) had biliary diversion (PIBD-14, PEBD-2). A total of 75 children (52 boys, age at symptom onset-5[2-7]mo and diagnosis-9[5-24] mo) with PFIC (ATP8B1-16, ABCB11-27, ABCB4-14, TJP2-8, USP53-6, MYO5B-2, NR1H4-1, KIF12-1) were enrolled. Consanguinity, ICP in mother and affected sibling were seen in 26 (34.6%), 24(32%) and 14 (18.6%) cases respectively. Majority (64, 85.3%) presented with cholestatic jaundice (neonatal [NC]- 34, infantile [IC]-30), 7 (9.3%) with DCLD (asites-7, HE-2, variceal bleed-5) and 4 (5.3%) as only pruritus."

Clinical • Cholestasis • Hematological Disorders • Hepatology • Pruritus • Thrombocytopenia • ABCB1 • ABCB4