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Gallstone Disease: Chenodeoxycholic Acid Therapy and Other Treatments

Gallstone disease, also known as cholelithiasis, is a medical condition characterized by the formation of “stones” or solid particles in the gallbladder or bile ducts. This article provides an overview of gallstone disease and treatment options, including chenodeoxycholic acid and other therapies. 

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Gallstone Disease Overview

Gallstone Disease Overview

The gallbladder is a small organ shaped like a pair found in the upper right side of the abdomen beneath the liver. The main role of the gallbladder is to store and concentrate bile, a digestive fluid that helps the body absorb and digest fats and fat-soluble vitamins in the small intestine.

Gallstones are small deposits or “stones” that develop in the gallbladder for various reasons, including:

  • An imbalance of cholesterol and bile salts in the gallbladder causing cholesterol gallstones (the most common type of gallstone) 
  • Conditions like cirrhosis and blood disorders where elevated bilirubin levels contribute to the development of pigment gallstones
  • Gallbladder motility issues caused by pregnancy, obesity, and some medications
  • Genetic factors, including obesity, rapid weight loss, female gender, advancing age
  • Diets high in saturated fats and low in fiber
  • Conditions such as metabolic syndrome and diabetes

Symptoms of gallstone diseases include:

  • Sudden and intense pain in the upper right or center of the abdomen which can radiate to the back or shoulder
  • Nausea and vomiting
  • Indigestion or a feeling of fullness and discomfort in the upper abdomen
  • Bloating and excessive gas production
  • Onset of jaundice, a disease characterized by yellowing of the skin and the whites of the eyes
  • Fever and chills
  • Pale stools and dark urine
  • Chronic diarrhea

The severity and combination of symptoms varies widely among individuals, and gallstones may remain asymptomatic for an extended period of time. Complications of the disease may require prompt treatment.

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How Chenodeoxycholic Acid Treats Gallstones

Chenodeoxycholic acid works by dissolving the cholesterol responsible for gallstone formation. It also limits cholesterol production in the liver and its absorption in the intestines, thereby reducing gallstone development. Additionally, it can lower the levels of other bile acids that may be detrimental to liver cells when they are elevated. The use of chenodeoxycholic acid use is limited by adverse effects, including diarrhea and increased levels of serum aminotransferase or cholesterol.

Gallstone Disease Treatments

Treatment for gallstones varies depending on the type of gallstone, the presence and severity of symptoms, and the patient’s overall health.

Treatment options for gallstones may include:

  • Dissolving gallstones primarily composed of cholesterol with medication such as ursodeoxycholic acid
  • Gallbladder removal through surgery
  • Endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasound (EUS) for gallstones that have migrated from the gallbladder into the bile ducts
  • Shockwave lithotripsy to break up gallstones within the gallbladder for patients who cannot undergo surgery
  • Oral dissolution therapy involving medications that promote the dissolution of gallstones
  • A “wait and see” approach for patients that have no symptoms to see if the disease resolves itself
  • Treatment with chenodeoxycholic acid (CDCA) to dissolve gallstones made primarily of cholesterol 

The choice of gallstone therapy is highly individual. Symptoms vary considerably between patients, and the right option depends on factors that include the severity of the condition and the patient’s health.

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Gallbladder Disease and CDCA FAQ

Gallstone disease, or cholelithiasis, is a condition where solid particles or “stones” form in the gallbladder or bile ducts. Gallstones can be composed of cholesterol, bilirubin, or other materials.

Gallstones can form due to various factors, including cholesterol imbalance, gallbladder motility issues, genetic factors, elevated bilirubin levels, diet, and specific medical conditions.

Symptoms of gallstone disease include abdominal pain, nausea, vomiting, jaundice, fever, dark urine, indigestion, bloating, and pale stools. Some people do not experience symptoms until extended progression of the disease. 

CDCA is a medication used to dissolve cholesterol gallstones. It works by modifying bile composition, reducing cholesterol production in the liver, and inhibiting its absorption in the intestines. CDCA also helps lower harmful bile acid levels in the liver.

The choice of treatment is highly individual and depends on factors like symptom severity, gallstone type, and the patient’s overall health. Healthcare professionals evaluate these factors to determine the most suitable treatment approach.

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