Bile acids for gallstones

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Bile acids work slowly to dissolve gallstones made of cholesterol. Pills are taken daily for up to 2 years.

Medicine is sometimes used in the small group of people for whom the risks of surgery are too high. People who are treated with medicine should meet the following criteria:

• The gallbladder functions normally, as seen on an oral cholecystogram (OCG) or a hepatobiliary (HIDA) scan.
• Gallstones are small [less than 0.6 in (1.5 cm) in diameter].
• Gallstones float in the gallbladder.
• Gallstones are not calcified. Gallstones that can be seen on X-ray usually contain calcium and will not dissolve.
• Symptoms caused by gallstones are mild or do not occur often.
• Surgery would be risky.
• No liver problems exist.
• The cystic duct, which connects the gallbladder to the common bile duct, is open and can allow stones to pass.

Bile acids can also be used to help prevent gallstones from forming during rapid weight loss. And they may be used after lithotripsy (extracorporeal shock wave treatment) to help gallstone fragments dissolve more quickly.

Because the gallbladder is not removed, gallstones often come back.

The main side effect of ursodiol is diarrhea. It also may cause nausea or headache.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Experts do not know what percentage of stones that recur will cause symptoms. Another round of treatment may be an option if symptoms recur.

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