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CDCA has been used as medical therapy to dissolve gallstones. [ 7 ] [ 8 ] Medical therapy with oral bile acids has been used in patients who have small cholesterol stones, and for patients with larger cholesterol gallstones who are unable or reluctant to have surgery.
The clinical course of biliary sludge can do one of three things: (1) it can resolve completely, (2) wax and wane, or (3) progress to gallstones. [ 1 ] [ 2 ] [ 3 ] If the biliary sludge has a cause (e.g. pregnancy), it oftentimes is resolved when the underlying cause is removed.
Ursodeoxycholic acid (UDCA), also known as ursodiol, is a secondary bile acid, produced in humans and most other species from metabolism by intestinal bacteria.It is synthesized in the liver in some species, and was first identified in bile of bears of genus Ursus, from which its name derived. [8]
Gallstones may result from increased saturation of cholesterol or bilirubin, or from bile stasis. Lower concentrations of bile acids or phospholipids in bile reduce cholesterol solubility and lead to microcrystal formation. Oral therapy with chenodeoxycholic acid and/or ursodeoxycholic acid has been used to dissolve cholesterol gallstones.
[8] [9] Gallstones are more common among women than men and occur more commonly after the age of 40. [2] Gallstones occur more frequently among certain ethnic groups than others. [2] For example, 48% of Native Americans experience gallstones, whereas gallstone rates in many parts of Africa are as low as 3%.
Gallstones can cause obstructive jaundice (if a small stone goes down and blocks the bile duct), porcelain gallbladder and gallstone ileus. The usual treatment for gallstones is surgical removal of the gallbladder - cholecystectomy. Laparoscopic cholecystectomy is a routine operation nowadays.