Ursodeoxycholic acid gallstones

Multidimensional LC has also been used to determine ursodeoxycholic acid and its conjugates in serum (14). These compounds are used in the treatment of cholesterol gallstones, hepatitis and bilary cirrhosis. These authors employed a traditional (10 X 4 mm) pre-column and a micro-bore (35 X 2 mm) analytical column that were interfaced by using a six-port switching valve. 

In the bile cholesterol is kept soluble by fats, phospholipids like lecithin and by bile acids. The important bile acids in human bile are cholic acid, chen-odeoxycholic acid or chenodiol and ursodeoxycholic acid or ursodiol. Bile acids increase bile production. Dehydrocholic acid, a semisynthetic cholate is especially active in this respect. It stimulates the production of bile of low specific gravity and is therefore called a hydrocholeretic drug. Chenodiol and ursodiol but not cholic acid decrease the cholesterol content of bile by reducing cholesterol production and cholesterol secretion. Ursodiol also decreases cholesterol reabsorption. By these actions chenodiol and ursodiol are able to decrease the formation of cholesterolic gallstones and they can promote their dissolution. 

Gallbladder effect. Seeds, administered orally to 20 adult males with mild hypercholesterolemia at a dose of 5.1 g/day for 40 days, reduced postprandial residual volume and increased volume of bile emptied b Gallstone prevention. Psyllium was investigated in a double-blind clinical trial to compare the effect of rational diet plus ursodeoxycholic acid vs a rational diet... 

Drugs like chenodeoxycholic acid (chenodiol) and ursodeoxycholic acid (ursodiol) can dissolve certain types of gallstones.28,45 These drugs decrease the cholesterol content of bile and may help dissolve gallstones that are supersaturated with cholesterol these drugs do not appear effective in the treatment of calcified gallstones.28... 

Petroni ML, Jazrawi RP, Pazzi P, et al. Ursodeoxycholic acid alone or with chenodeoxycholic acid for dissolution of cholesterol gallstones a randomized multicentre trial. The British-Italian Gallstone Study group. Aliment Pharmacol Ther. 2001 15 123-128. 

Ursodeoxycholic acid can be used to dissolve cholesterol gallstones it supplements the bile acid pool... 

Bear bile contains bile acids, cholesterol, and phospholipids (phosphatidylcholine, phosphatidylethanolamine, and phos-phatidyhnositol). It has been used for centuries in traditional Chinese medicine to treat liver and eye complaints and convulsions, and, in combination tvith curcuma and capil-laris, gallstones and cholecystitis. More recently it has been touted as a treatment for stroke on the basis of animal experiments. It has few or no adverse effects, but by the same token probably has little or no efficacy, although it does contain ursodeoxycholic acid, which in purified form is effective in managing gallstones. 

The bile acids are used in the long-term treatment of cholesterol gallstones. Ursodeoxycholic acid is the 7-epimer of chenodeoxycholic acid. TauroursodeoxychoUc acid is a derivative of ursodeoxycholic acid. 

Lichenoid eruptions have been reported in a 61-year-old man with gallstones who took ursodeoxycholic acid 600mg/day for a few weeks (12). The eruption improved on withdrawal, but recurred when ursodeoxycholic acid was reintroduced 3 months later. 

Ursodeoxycholic acid A naturally occurring bile acid (originally isolated from the bile of bears) that is present in minor concentrations in the bile (approximately 1 to 10 percent). When administered orally, it helps to dissolve cholesterol gallstones. 

Ursodeoxycholic acid (3a,7p-dihydroxy-5p-cholan-24-oic acid) is present in human bile in small quantities and is of interest because of its therapeutic use as a gallstone-dissolving agent (D8). This bile acid is thought to be... 

F6. Fromm, H., Gallstone dissolution and the cholesterol-bile acid-lipoprotein axis. Propitious effects of ursodeoxycholic acid. Gastroenterology 87, 229-233 (1984). 

Ursodiol (ursodeoxycholic acid—UDCA), a bile acid with gallstone-stabilizing properties (8 to 10 mg/kg/day), is used for dissolution of radiolucent gallbladder stones and to increase the flow of bile in patients with bile duct prosthesis or stents. 

Fusarium equiseti [1096], The product (ursodeoxycholic acid) is capable of dissolving cholesterol and thus can be used in the therapy of gallstones. 

Effect of Chenodeoxycholic and Ursodeoxycholic Acid Treatment on Intestinal Microflora of Patients with Cholesterol Gallstones Annamaria Ferrari, Novella Pacini, and Enrica Canzi... 

Despite our increased knowledge of the synthesis, secretion and enterohepatic circulation of bile salts, several aspects of the effects of these sterol metabolites on the physiology of the intestine itself have not been emphasized and are poorly understood. This becomes of greater significance when we consider that bile acids, particularly chenodeoxycholic acid and ursodeoxycholic acids, are employed for gallstone therapy there are several dietary influences on the enterohepatic circulation of bile acids and on bile acid excretion (e.g. fats and dietary fibers) increased colonic bile acid concentrations have been implicated in the promotion of colorectal cancer and there appears to be an inverse relationship between cholesterolemia and colon cancer. 

The first medical cholelitholysis in man was obtained in 1972 by Danzinger and Hofmann with chenodeoxycholic acid (cheno) (1). Trhee years later, in Japan, Makino showed that also ursodeoxycholic acid (urso), the 7 epimer of cheno, could dissolve cholesterol gallstones in vivo, in man (2). 

Also urso-treated patients seem to respond to treatment in a manner which is inversely related to stone size. In a recent review Bachrach and Hofmann (5) analyzed the results of several studies with ursodeoxycholic acid and observed that patients with stones less than 5 mm in diameter have a 30% chance of their gallstones disappearing within one year or even 6 months patients with stones 5-10 mm in diameter have a dissolution rate of about 18% in a period of time not shorter than a year and in patients with stones more than 10 mm in diameter any dissolution which might occur will require more than a year and the expected success rate is probably 10%. 

EFFECT OF CHENODEOXYCHOLIC AND URSODEOXYCHOLIC ACID TREATMENT ON INTESTINAL MICROFLORA OF PATIENTS WITH CHOLESTEROL GALLSTONES... 

The positive results of treatment of cholesterol gallstones with chenodeoxycholic acid (3a,7a-dihydroxy-53-cholan-24-oic acid) (CDA) and its epimer ursodeoxycholic acid (3a,73-dihydroxy-53-cholan-24-oic acid) (UDA) are well known. In the colon these bile acids are mainly 7a-dehydroxylated by intestinal microflora into lithocholic acid (3a-monohydroxy-53-cholan-24-oic acid) (LCA), whose toxicity at the hepatic level has been demonstrated in different higher animals. 

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