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Bile Acid Malabsorption - High Soluble Fiber Diet?

Hi everyone, I have recently been diagnosed with BAM. Unfortunately being able to see a nutritionist is a long wait, and was wondering if anyone had any ideas of what to eat to help the illness?

BAM is when the bile acid is not reabsorbed from the small intestine to the stomach. Causing diarrhoea and stomach pain. I have been looking around and new ideas circulating of a high soluble fibre diet is being recommended to soak up some of the bile acid.

So my questions are, does anyone know any really easy recipes that are high in soluble fibre. and does anyone have any experience with BAM, and if so, what did you do?

Thank you

Bile is released primarily in response to fat in the diet, and more particularly for long chain triglycerides. Medium chain triglycerides do not significantly stimulate bile release since they can be taken directly into the liver and used for energy. Any normal dietary fat or oil is going to have a long of long chain triglycerides. Even coconut which is high in medium chain triglycerides is still about 30% long chain triglyceride.

Medium chain triglyceride oil (MCT oil) contains no long chain fatty acids. Usually it doesn’t even contain 12 carbon fatty acids, just 8, 10 or both. This means that in theory you could use MCT oil to practically eliminate bile production. You can also theoretically cook with them or make dressings etc.

I thought that coconut flour might be good for absorbing excess bile too. It is fairly low in long chain fatty acids and has significant fiber.

I have Bile Acid Malabsorption; suffered chronic diarrhea maybe 6-12 times per day for the last 14 years or so.

Only 2 things have helped.

1, a med called Cholestyramine or Questran. It is a horrifically disgusting powder that you mix with any liquid besides milk, and drink 30-45 minutes before you eat. It DID SOLVE my problem, but to the extreme— it made me constipated and gave me excruciating hemorrhoids.

That was worse than having to be in the toilet constantly.

2, what I do NOW, that has made me need to use the restroom only twice per day: psyllium husk fiber.

It TOTALLY cured me. Literally LIFE CHANGING.
I take three tablespoons per day mixed into a drink, between meals, and my life is normal again finally!

The brands I use are Organic India Psyllium and Yerba Prima Psyllium Whole Husks.

I know this post is old, but I hope the OP sees this, because the psyllium is a miracle for me.

My diet (in case anyone was interested,) is:

2 cups black beans
2 cups fairlife lactose free whole milk
6 oz chicken breast
6 oz 93% lean ground beef
4 hard boiled eggs
2 tbsp olive oil
1 slice of whole grain bread
8 tbsp peanut butter
2 scoops (50g protein) NOW whey protein isolate
1 piece of sugar free chocolate
Black Coffee
Lots of water with lemon

About 2900 calories.

I feel fantastic.

I’m 5’11”, and have gone from 247 at 35% body fat to 230 at 25% body fat. I do bodybuilding exercises 6 days a week, no cardio.

hey speedyone,

really awesome and helpful post! Thank you! Can I ask please how do you use the psyllium husk fiber exactly? Do you let them soak up the water or do you mix it in and drink it right away? Some people let them sit for a while to soak up and some drink it immediatley!?!?

I´m also interested how do you use the olive oil in your diet? Do you cook with them or do you add the oil to your meal after cooking?



I mix the psyllium husk with some lemon water, and just drink immediately. It’s unflavored; I don’t drink sweetened drinks, so I just chug it down quickly. If you let it sit, it will become kind of thick, which I don’t like the sensation of drinking.

I just mix in one tablespoon of olive oil into my main meals (which have beef and chicken,) AFTER they have been cooked. I don’t think it matters if you use the olive oil plain, or if you use it to cook with. I mix it into my food AFTER I cook it, because I track my calories and weigh my food, use measuring spoons, etc.

The psyllium husk however WILL interact with medications. It will negate their effects if you take it at the same time. Therefore, I take my meds 1 hour BEFORE I drink the psyllium, or 2 hours AFTER I drink it. It is kind of a hassle to do this, but since it has freed me from a life of being in the bathroom all day, it’s worth it to me.

Hope that helps!

The key to dealing with bile acid malabsorption is to try to slow down the digestive process. The psyllium and beans really helps, although you could certainly use other types of high fiber foods to help with this.

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Thank you for sharing this tip about the pysllium husk fibre. Are you taking 3 tbsps once per day - between breakfast and lunch? or more than that? I really want to stop taking cholestyramine and want to try the fibre…hoping it works for me too!