Abstract
Gallstone dissolution with oral bile acid therapy is an attractive alternative to conventional surgical operations. Gallstones result from metabolic disturbance; reversing this metabolic problem seems a logical treatment. In patients with cholesterol gallstones, the bile is invariably supersaturated with cholesterol and oral bile acid therapy aims to reverse the process of cholesterol crystalization. Chenodeoxycholic acid (CDCA) and urodeoxycholic acid (UDCA) inhibit biliary cholesterol secretion and desaturate bile. Current therapy combines these in half the monotherapeutic dosages to preserve the dissolution efficacy of CDCA while minimizing side effects. Usual daily dosages are approximately 7 mg/kg of UDCA given together at bedtime.
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