What is the mechanism of action of bile-acid binding resins?

The bile-acid sequestrants are highly positively charged and bind negatively charged bile acids Because of their large size, the resins are not absorbed, and the bound bile acids are excreted in the stool 95% of bile acids are normally reabsorbed ➔ interruption of this process depletes the pool of bile acids hepatic bile-acid synthesis increases (cholesterol hydroxylase catalyzes the rate-limiting step in conversion of cholesterol to bile acids) hepatic cholesterol content declines, production of LDL receptors increases and lead to the increase of the LDL clearance and decrease LDL levels from the blood