[2] Bile acid sequestrants are large polymeric structures, and they are not significantly absorbed from the gut into the bloodstream.
Chronic diarrhea may be caused by excess bile salts entering the colon rather than being absorbed at the end of the small intestine (the ileum).
Many patients find them hard to tolerate, as although the diarrhea may improve, bloating and abdominal pain can worsen.
[8][9] In chronic liver diseases such as cirrhosis, bile acids may deposit in the skin, causing pruritus (itching).
By inhibiting the enterohepatic circulation, more L-thyroxine will be lost through defecation, thus lowering body thyroxine levels.
As bile acid sequestrants are designed to stay in the gut; in general, they do not have systemic side effects.
Because bile acid sequestrants are not well-absorbed from the gut, they are generally regarded as safe in pregnant women.