Colestyramine slows gastric emptying of liquids and reduces appetite in healthy subjects

Abstract

This study provides the first evidence that colestyramine significantly slows liquid gastric emptying and reduces appetite in healthy humans. Colestyramine therefore presents an attractive gut-brain signaling research tool in that it is not absorbed and thus lacks potentially confounding postabsorptive effects. Furthermore, with clear effects on gastric emptying and appetite, colestyramine now merits consideration as a trial therapeutic strategy for appetite suppression and weight loss.

Effect of chenodeoxycholic acid and the bile acid sequestrant colesevelam on glucagon‐like peptide‐1 secretion

“…The delayed gastric emptying observed after CDCA instillation may have reduced glucose excursions, had it been administered with a meal, as gastric emptying is known to be an important determinant of postprandial glucose excursions ; however, as the paracetamol absorption test predominantly reflects the liquid phase of gastric emptying, these results may not directly translate into gastric emptying of solid food. The BAS cholestyramine has been shown to delay gastric emptying of liquid meals and reduce appetite in healthy control subjects ; however, we did not observe an effect of colesevelam on gastric emptying. No differences in gallbladder volume between the different interventions or between the groups were observed.…”

Bile acid binding resin improves hepatic insulin sensitivity by reducing cholesterol but not triglyceride levels in the liver

“…Enhanced GLP-1 secretion was also observed in humans treated with BAR [13]. Consistent with these findings, it was reported that BAR reduced gastric emptying in healthy subjects [14]. Considering that the improvements in glycaemic control in humans are not necessarily accompanied by reduced visceral fat mass, which is observed in animal studies, the mechanism of action of BAR in humans still needs to be determined [8].…”

‘The way to a man's heart is through his gut microbiota’ – dietary pro- and prebiotics for the management of cardiovascular risk

“…We also showed that β-glucan increases the relative abundance of bifidobacteria in C57BL/6 mice fed high-fat diet, and regluates food intake by suppressing neuronal signals in appetite centres of the brain ( 20 ) . The BA sequestrant, colestyramine has been shown to trigger satiety via reduced gastric emptying in healthy human subjects ( 168 ) , suggesting that factors controlling the enterohepatic circulation of BA may contribute to satiety as well as regulating blood cholesterol levels. Interestingly, recent studies showing that probiotic microorganisms can reduce cholesterol uptake from the intestine via modulation of BA signalling, discussed earlier ( 29 , 30 ) raise another possibility that oats and prebiotics in general (including certain polyphenols) may selectively stimulate gut bacteria capable of hydrolysing bile salts modifying the enterohepatic circulation of BA both in terms of quantity and chemical profile ( 39 , 79 , 169 – 171 ) .…”