gallstone oral dissolution

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The oral intake of bile salts such as cholic acids will dissolve some gallstones. They reduce intestinal absorption of cholesterol causing the cholesterol concentration in bile to fall. Also, they inhibit the microsomal enzyme HMG CoA reductase which is involved in cholesterol syntheis. They may also increase the concentration of bile salts in bile. Thus, cholesterol within stones is in a more favourable environment to solubilize.

Treatment is required for a period of months to years. Half of patients experience diarrhoea. Plasma aminotransferase levels are increased in a third. Follow-up is by annual ultrasound.

Dissolution is achieved in about 50% of patients. Up to 40% of patients redevelop stones, 25% of which, have symptoms.

Last reviewed 01/2018