Is there any medication to treat gallstones?
Is there any treatment other than surgery for gallstones? Here we explain it to you.
This article is one of the most important since it is what the patient will finally receive from his surgeon, the offer of a treatment that will resolve his disease. Once the diagnosis is confirmed, the treatment of gallstones (cholecystolithiasis) does not have much margin of options, there are two main ones (and only one is effective), medical treatment and surgical treatment.
MEDICAL TREATMENT
When talking about medical treatment, I am going to spoil the end of the story by telling you that it is neither useful nor highly recommended. The reasons for this are very simple, to this day medications for the treatment of gallstones are considered to be moderately effective. They have to be taken for months and their objective is to dissolve the stones. But even in the case that the stones are dissolved, the tendency to re-form them is still present, in almost all cases they will re-form after the treatment is suspended.
This is why, unfortunately, the medical treatment of cholecystolithiasis is useless. A time when these medications have a place is when the patient has a "stone-forming" situation and they are used preventively, seeking to prevent them before they are formed and taking into account that this stone-forming situation will give way after a few months, a clear example is in patients who undergo obesity surgery, as mentioned in the article on risk factors for gallstones, since during the weight loss procedure an imbalance in the components of bile is caused, as mentioned in the article on symptoms of cholecystolithiasis.
The only other circumstance in which medical treatment has a place is when the patient refuses surgery or his health condition does not allow him to undergo a surgical procedure. In general, when this situation arises, it is better to seek to improve his health condition in order to proceed with the surgery in a safer way as soon as possible.
WHAT ARE THE MEDICATIONS FOR THE TREATMENT OF GALLSTONES?
The drugs or substances most commonly used are bile salts, both chenodeoxycholic acid and ursodeoxycholic acid, which have been tried alone or in combination.
Chenodeoxycholic acid (CDCA): is able to reduce biliary cholesterol saturation and dissolve stones especially when they are smaller than 15 mm in a functioning gallbladder, in 60% of patients the goal of dissolving the stones is achieved; a process that takes at least six months, it should be noted that although this figure of 60% sounds encouraging, most patients who undergo this type of treatment form stones again after discontinuing the medication. Not only that, but the time required to dissolve the stones actually ranges from a minimum of 6 months to 3 years!
It also has the following side effects:
- Diarrhea
- The drug is potentially hepatotoxic (can damage the liver).
- Causes gastrointestinal symptoms at the onset of treatment
- Only dissolve cholesterol stones
- The approximate monthly cost is 500 pesos, which extrapolated to the time required for the medication the final cost can go from 3000 thousand pesos to 18 thousand pesos, without taking into consideration that to determine if the stones have dissolved, repetitive imaging studies are needed every few months and this also represents an expense of between 800 to 1500 pesos per study depending on the costs of ultrasound in your area. And as we said, the fact that the stones have dissolved is not a guarantee that they will not form again soon after stopping the treatment.
Ursodeoxycholic acid (UDCA): in summary, the indications for this drug and its results are very similar to those of AQDC.
Reference
Rev Fac Med UNAM Vol.43 No.4 July-August, 2000
Extracorporeal lithotripsy
Biliary lithotripsy is recommended in symptomatic patients with high surgical risk or who refuse cholecystectomy, in summary what is done is the destruction of the stones with sound waves, this method is much more frequently used to treat stones in the urinary tract where you can not remove a kidney or ureter to solve the problem, instead our body can do without the gallbladder.
HOME OR "NATURAL" REMEDIES FOR GALLBLADDER STONES
This issue, as a surgeon, creates a lot of conflict for me because unfortunately it is very common to see in the office cases of patients who undergo home remedies recommended by family or friends without knowing the serious consequences that this can have!
The mechanism by which these home remedies for gallbladder stones work is to provoke strong contractions of the gallbladder so that the stones are expelled from the organ and reach the intestine to be evacuated with the feces, in theory it sounds logical or feasible as an option, however in reality something of the following happens:
- The patient ingests the natural/home remedy and suffers one of the most intense pain episodes of his life, with no guarantee that the stones have come out.
- If you do not end up in the hospital because of the intensity of the pain and get the stones expelled, no one can assure you that the stones will actually reach the intestine.
- If they do not reach the intestine, it means that one or more of the stones are stuck in the common bile duct (choledocholithiasis), a situation that puts you at an imminent risk of developing biliary pancreatitis, a disease that can be mild, moderate or severe, even leading to death in certain cases.