Investigating a Bile Acid Binder to Help Adults with Chronic Diarrhoea

Participants with functional chronic diarrhoea will receive 14 days of cholestyramine, a bile acid sequestrant in powder form, to drink dissolved in liquid according to manufacturer's guidelines: "QUESTRAN LITE should be taken mixed with water, juice or highly fluid foods. When mixing individual sachets for immediate use, place the contents of a 4g sachet of QUESTRAN LITE on the surface of 100-150mL water or fruit juice (200-300mL for an 8g sachet of QUESTRAN LITE). Mix immediately by stirring vigorously or preferably by shaking in a Questran Lite shaker. Continue stirring or shaking until mixture is even. After dosing, rinse the container to ensure full dose. Alternatively, QUESTRAN LITE may be mixed with highly fluid soups, pulpy fruits with a high moisture content (e.g., apple puree or crushed pineapple), or if care is taken to avoid excessive foaming, a carbonated beverage.. Specifically, 4g of cholestyramine is equivalent to 4.7g Questran Lite (prescription brand name) per day in the evening or morning, increasing it to up to 12g cholestyramine /14.1g of Questran Lite over 14 days. Begin with 4g cholestyramine (4.7 QUESTRAN LITE) in the morning or evening, increasing to the required maintenance dose over 2 to 4 weeks." There is no strict protocol since the dose has to be adjusted individually, with input from the medical officer, depending on tolerability. Adherence is not monitored, as it is a prescription drug, and there are no lab tests available for monitoring.