Ursodiol: MedlinePlus Drug Information

pronounced as (er’ soe dye ol)

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Ursodiol is used to dissolve gallstones in people who do not want surgery or cannot have surgery to remove gallstones. Ursodiol is also used to prevent the formation of gallstones in overweight people who are losing weight very quickly. Ursodiol is used to treat people with primary biliary cholangitis (PBC; formerly known as a primary biliary cirrhosis; an autoimmune liver disease). Ursodiol is in a class of medications called gallstone dissolution agents. It works by decreasing the production of cholesterol and by dissolving the cholesterol in bile to prevent stone formation and by decreasing toxic levels of bile acids that accumulate in primary biliary cirrhosis.

Ursodiol comes as a capsule and as a tablet to take by mouth. It is usually taken two or three times a day with or without food to treat gallstones and two times a day to prevent gallstones in people who are losing weight quickly. If you are taking the tablets to treat primary biliary cholangitis, they are usually taken 2 or 4 times a day with food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ursodiol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you need to break the tablet for your specific dose, place the tablet on a flat surface with the scored section on the top. Hold the tablet with your thumbs close to the scored part and apply gentle pressure to snap the tablet into two parts. Swallow the half tablet with water; do not chew the half tablet. Because the tablet has a strong bitter taste, store the other tablet half in a separate container from the whole tablets. Use the stored half tablet within 28 days. If you have any questions, your doctor or pharmacist will tell you how to break the tablets and how you should take and store them.

This medication must be taken for months to have an effect. If you are taking ursodiol capsules to dissolve gall stones, you may need to take ursodiol for up to 2 years. Your gallstones may not completely dissolve, and even if your gallstones do dissolve you may have gallstones again within 5 years after successful treatment with ursodiol. Continue to take ursodiol even if you feel well. Do not stop taking ursodiol without talking to your doctor.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking ursodiol,

• tell your doctor and pharmacist if you are allergic to ursodiol, bile acids, or any other medications, or any of the ingredients in ursodiol tablets and capsules. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• The following nonprescription or herbal products may interact with ursodiol: antacids that contain aluminum. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking ursodiol. Do not start any of these medications while taking ursodiol without discussing it with your healthcare provider.
• tell your doctor if you have bile duct blockage. Your doctor will probably tell you not to take ursodiol. Your doctor also will probably tell you not to take ursodiol if you have a type of gallstone that will not dissolve or if surgery is a better choice for your condition.
• tell your doctor if you have had gastrointestinal surgery. Also, tell your doctor if you have or have ever had variceal bleeding (bleeding in the esophagus or stomach), Crohn’s disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever), or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking ursodiol, call your doctor.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Ursodiol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness
• headache
• cough, fever, sore throat, runny nose, or other signs of infection
• frequent urination or pain when you urinate
• muscle pain
• hair loss

Some side effects can be serious.

If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• indigestion
• stomach pain
• nausea
• vomiting
• diarrhea
• constipation
• hives; rash; itching; swelling of the face, eyes, mouth, throat, tongue, lips, hands, feet, ankles, or lower legs; or difficulty breathing or swallowing

Ursodiol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can’t be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• diarrhea

• Actigall^®
• Urso^® 250
• Urso^® Forte

Last Revised – 03/15/2023

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Gallbladder Sludge: Symptoms, Causes, and Treatment

Biliary sludge can cause abdominal pain after eating along with other symptoms. Treatment can depend on the severity and may include treating the underlying cause, medications, or gallbladder removal.

The gallbladder is located between the intestines and the liver. It stores bile from the liver until it’s time to release it into the intestines to aid in digestion.

If the gallbladder doesn’t empty completely, particles in the bile, like cholesterol or calcium salts, can thicken from staying in the gallbladder for too long. They eventually become biliary sludge, which is commonly referred to as gallbladder sludge.

Some people who have gallbladder sludge will show no symptoms and never know they have it. Others will experience symptoms similar to an inflamed gallbladder or gallbladder stones.

The primary symptom is often abdominal pain, especially on your upper right side under the ribs. This pain may increase shortly after a meal.

Other symptoms can include:

• chest pain
• right shoulder pain
• nausea and vomiting
• clay-like stools

Gallbladder sludge forms when bile remains in the gallbladder for too long. Mucus from the gallbladder can mix with cholesterol and calcium salts, combining to create the sludge.

Gallbladder sludge seems to be more common during pregnancy, especially if you’re following a strict diet.

While gallbladder sludge is not a common problem, there are certain people who have a higher risk of developing it. Groups who are at a higher risk include:

• women, who tend to have higher rates of gallbladder problems than men
• people with Native American ancestry
• people who get nutrition through an IV or other alternatives to food
• people who are critically ill
• people with diabetes
• people who were very overweight then lost weight quickly
• people who have had an organ transplant

If you’re experiencing abdominal pain, your doctor will ask about your medical history and symptoms. They’ll then perform a physical exam where they’ll press different places on your abdomen.

If they suspect that your gallbladder may be the source of the pain, they’ll likely order an abdominal ultrasound, which can very accurately detect gallstones.

If your doctor diagnoses you with gallstones or gallbladder sludge after the ultrasound, they may run tests to determine the cause of the sludge.

These tests will likely include a blood test, which can examine your cholesterol and sodium levels. Your doctor may also run blood tests to make sure your liver is functioning properly.

Doctors will sometimes find your gallbladder sludge by accident while looking at the results of a CT scan or ultrasound that was ordered for something else.

Sometimes, gallbladder sludge will resolve without causing any symptoms or needing treatment. In other situations, it can lead to gallstones. Gallstones can cause upper abdominal pain and may require surgery.

In some cases, these gallstones can cause an obstruction in the bile duct. This is a medical emergency and requires immediate treatment.

Gallbladder sludge can cause or contribute to cholecystitis, which is an inflamed gallbladder. If your gallbladder causes frequent or chronic pain, your doctor will likely recommend removing it entirely.

In very severe cases, inflammation can cause erosion in the wall of the gallbladder, leading to a perforation that leaks the contents of the gallbladder into the abdominal cavity. This is most common in older adults.

Gallbladder sludge may also cause acute pancreatitis, which is inflammation of the pancreas. This can cause enzymes to be active in the pancreas instead of the intestines, leading to inflammation.

The inflammation can cause a systemic response, leading to shock or even death. This can occur if the gallbladder sludge or gallstones block the pancreatic duct.

Many people with gallbladder sludge will never even know they had it, especially in cases where the cause is only temporary.

If the gallbladder sludge leads to further complications or causes chronic pain, your doctor may recommend removing the gallbladder altogether. Gallbladder sludge typically isn’t a problem unless it’s experienced over a long period of time or causes symptoms.

To prevent gallbladder sludge, try to eat a healthy, well-balanced diet with high fiber foods like whole grains, fruits, vegetables, and beans, as well as healthy fats like fish oil or olive oil. Try to avoid or cut down on refined carbs, sugar, fried foods, and trans fats.

Gallbladder Stones: Main Causes, Symptoms and Treatment Options – July 13, 2021

1

Where do stones come from?

To understand this, you must first understand what bile is. It is necessary for the digestion of food, it is formed in the liver, and only accumulates in the gallbladder, so that later it pushes bile into the duodenum. The main components are acids, cholesterol, pigments, lecithin, calcium and mucin-glycoprotein gel. When bile stagnates, crystals fall to the bottom of the bladder and stones form. They come in different sizes, from a few millimeters to a chicken egg, single and multiple.

– The main causes of stone formation include hereditary disorders of cholesterol metabolism, overeating, eating foods rich in cholesterol, fasting or irregular meals, overweight, multiple pregnancies, long-term use of contraceptives and, in general, female gender, chronic pancreatitis, cholecystitis, – says Natalya Ignatova, gastroenterologist of the gastroenterological department of the New Hospital.

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2

How is cholelithiasis manifested?

In most patients, the presence of stones does not cause any symptoms – they are found incidentally during an examination for another reason. However, they can also cause significant inconvenience.

— Pain in the abdomen, more often in the area of ​​the right hypochondrium, may disturb, — says Ignatova. – Pain can be given to the back or to the right shoulder blade, right shoulder, interscapular region. They will be associated with food, they can be bursting, pressing, short-term. In an acute condition – biliary colic – the pain can be very intense, cutting, intolerable. Also, cholelithiasis can be manifested by nausea, vomiting, stool disorders – loosening, discoloration, alternating constipation and loose stools.

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3

How is gallstone disease treated?

The first thing to know is that you cannot try to dissolve stones on your own. The fact is that the stones differ from each other in composition, and it is possible to truly determine only on the operating table after extraction. One can only assume their chemical composition by concomitant diseases and frequency of occurrence.

There are several options for treating stones. Medicamentous – dissolution of stones with preparations of bile acids – ursodeoxycholic. The effect of such treatment is up to 60%, – says Ekaterina Skvortsova, general practitioner, therapist at the Medsi clinic. — Shock wave cholelithotherapy — has a limited range of applications. And finally, laparoscopic cholecystectomy is an operation.

— Patients are prescribed ursodeoxycholic acid preparations (Ursosan, Ursofalk, Exhol, Urdox, etc.). Taking therapy in courses, it is possible to restore the normal flow of bile, get rid of congestion, which means there will be no reason for the formation of stones in the future, says Natalia Ignatova. – In the presence of rare episodes of pain syndrome, the situational use of antispasmodics (Drotaverine, Ditsetel, Buscopan, etc.) is acceptable to relieve symptoms.

And the best treatment is, of course, prevention.

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How to prevent gallstone disease?

Basic prevention is the general principles of rational nutrition. Also important is the normalization of body weight, the mode of work and rest.

“It is necessary to exclude long breaks between meals and overeating, drink enough water per day (at least 2 liters per day), limit the consumption of fatty, smoked foods, fast food, carbonated lemonades, alcohol,” says Skvortsova. – Eat foods should be rich in vegetable fiber, calcium, vitamins, vegetable oils, protein – lean meats, fish. You need a fractional 4 meals a day in moderate portions. It is also necessary to timely identify and treat other diseases of organs and systems.

She notes that phytotherapy for the prevention of gallstone disease is really effective, but the selection of the necessary components, frequency, duration of courses should be determined by the doctor. Independent attempts to “cleanse the liver” often lead to exacerbation, gastritis, inflammation of the intestine.

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What to do if the disease has already been found?

In addition to the basic treatment tactics, patients require special nutrition. The approach to nutrition for people suffering from gallstone disease is Pevzner’s diet number 5.

— Eat small meals 5-6 times a day, avoid very hot or cold foods. Limit foods rich in cholesterol, says Ekaterina Skvortsova. – The use of foods rich in vitamins A, B, C, magnesium – reduce the crystallization process. Weekly it is necessary to spend fasting days on cucumbers, kefir. Limit tea, coffee, dark chocolate.

In case of cholelithiasis, it is necessary to adhere to diet No. 5

Infographics: Vitaly Kalistratov / Network of city portals

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What else to read about medicine?

• Treating the pancreas: how to live with pancreatitis
• Liver diseases: diseases that people learn about too late
• Stomach pain: how not to harm yourself by trying to relieve symptoms

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Ekaterina Bormotova

Journalist of the national editorial office

GallbladderGastroenterologistDiseases of the gastrointestinal tract

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Stones grow from it: 8 reasons why sand forms in the gallbladder

• Health

According to doctors, over the next two years, in 14 percent of cases it turns into stones, and in 6 percent it causes attacks of biliary colic.

August 31, 2022

Source:

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Sand, suspension or sediment in the gallbladder is medically called “biliary sludge”. It is formed, as a rule, due to a supersaturation of bile with cholesterol crystals.

Even gallstones can develop for a long time without any symptoms, what to speak of sand or sediment – they can only be seen on an ultrasound of the abdominal organs.

There are several types of biliary sludge, and in some cases you can do nothing about it – it will pass by itself. However, not always.

– According to observations, over the next 2 years, sludge disappears in 18% of cases, disappears and reappears in 60%, gallstones form in 14%, attacks of biliary colic occur in 6% of cases ( the most common manifestation of gallstone disease – Ed. ), – gastroenterologist Maria Lopatina said in her telegram channel.

The doctor named 8 factors that increase the risk of gallstones and sediment.

1. female,

2. pregnancy, especially repeated,

3. postmenopausal hormone replacement therapy,

4. gallstones in close relatives,

5. overweight,

6. diabetes mellitus,

7. rapid decline weight (more than 1.5 kilograms per week),

8. cyclic changes in body weight (alternating weight loss and weight gain).

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How to protect yourself from gallstone sand

According to a gastroenterologist, there are 3 main ways to prevent gallstone and sediment. They are quite simple and understandable. It is

• Move more . You reduce physical activity, the risk of formation of both sand and gallstones increases.

• Eat fewer high-calorie foods . For prevention, it is useful to reduce the total calorie content, as well as the inclusion in the diet of poly- and monounsaturated fats (for example, nuts), as well as dietary fiber (vegetables, fruits, cereals).

• Eat regularly . Eating regularly reduces congestion in the gallbladder – it empties more often.

If sand still appears

According to Maria Lopatina, ursodeoxycholic acid (UDCA) preparations are used to dissolve sand and sediment in the gallbladder – this group includes more than a hundred drugs with different names. Their task is to “dissolve” cholesterol crystals (the basis of biliary sludge) and make bile more fluid. However, it is important to take them strictly for their intended purpose – to observe the regimen, dosage and duration. Otherwise, the gastroenterologist warns, it will be difficult to achieve the expected “dissolution” effect.

– Drugs are prescribed according to the weight of the patient, the entire dose is taken at night or divided into two doses: in the evening and at night. This is important, because I met in the appointments the administration of UDCA preparations 3 times a day in order to dissolve the suspension. The duration of admission is 3 months, then the control of ultrasound of the gallbladder to assess the dissolution of the sludge, the doctor added.

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How to understand that you have bile stasis

Bile stasis (cholestasis), when the flow of bile from the liver to the duodenum is partially or completely disrupted, often goes unnoticed. Ultrasound of the abdominal organs is considered the most common and early diagnostic method. If you do not notice or do anything for a long time, symptoms may appear. The fact that not everything is in order with the outflow of bile can be indicated by these 7 signs:

1. heaviness and pain in the right hypochondrium,

2. skin itching,

3. bitterness in the mouth,

5. bloating;

7. yellowness of the sclera and skin.

Also, congestion can be seen in the blood test. As the medical director of the NACFF laboratory Olesya Generalova said, the very first and reliable marker of bile stasis is the presence of bile acids in the blood serum.