Ursodeoxcholic acid

Introduction

Ursodeoxycholic acid is a preparation for the treatment of small gallstones containing cholesterol (cholelithiasis). In Germany about 15 to 20% of people suffer from gallstones. Women are more frequently affected than men.

In addition to the female sex, typical risk factors include overweight (obesity), old age (over 40 years) and the presence of gallstones in first-degree relatives. In 80% of cases, gallstones are stones containing cholesterol. Only about 25% of patients with gallstones show symptoms. This typically results in right-sided pain in the upper abdomen, which can also radiate to the shoulders or back.

Indications for ursodeoxycholic acid

Ursodeoxycholic acid is used to treat gallstones (cholelithiasis), which are made up of cholesterol. Important additional requirements for use are size (<15mm), a functional gallbladder and other findings from ultrasound diagnostics (e.g. no visible shading in the area of the gallstone). Furthermore, ursodeoxycholic acid can also be used in the treatment of liver cirrhosis. The aim here is to prevent the progression of liver cirrhosis caused by chronic inflammation of the bile ducts or a backlog of bile fluid (e.g. in the context of primary biliary cirrhosis). In rare cases, ursodeoxycholic acid is also prescribed to treat inflammation of the stomach lining caused by a backflow of bile from the small intestine into the stomach (biliary reflux gastritis).

How does ursodeoxycholic acid work?

Gallstones are caused by an imbalance of the various substances found in the bile. In addition to bile acids, the bile also contains dissolved substances (e.g. cholesterol). A high proportion of cholesterol combined with a low concentration of bile acids leads to the precipitation of cholesterol-containing stones within the bile ducts.

Ursodeoxycholic acid, which also occurs naturally in the bile in very low concentrations, counteracts the formation of gallstones in various ways and also leads to the dissolution of small stones containing cholesterol. On the one hand, ursodeoxycholic acid inhibits the absorption of cholesterol from the intestine into the human body, while at the same time also reducing the release of cholesterol from the liver cells into the bile. On the other hand, ursodeoxycholic acid stimulates the release of bile acids from the liver cells into the bile fluid.

Due to the lower cholesterol and higher bile acid concentrations, the formation of cholesterol-containing gallstones can be prevented and at the same time small, already existing stones can be dissolved. In addition, ursodeoxycholic acid also has a cell-protective effect by inhibiting chronic inflammatory reactions. Thus liver cells damaged by chronic inflammation can be protected and the progression of liver cirrhosis can be delayed.