Bile acids for gallstones

Examples

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Brand Name	Chemical Name
Actigall	ursodiol

How It Works

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

• These medicines help prevent gallstones from forming during rapid weight loss.
• They may be used after lithotripsy (extracorporeal shock wave treatment) to help gallstone fragments dissolve more quickly.

Why It Is Used

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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 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 underlying liver problems exist.
• The cystic duct, which connects the gallbladder to the common bile duct, is open and can allow stones to pass.

How Well It Works

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

Side Effects

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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.)

What To Think About

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

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Credits

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Author	Monica Rhodes
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Last Updated	August 2, 2007