Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Bile salts, particularly in the form of ursodeoxycholic acid (UDCA), are scientifically validated for the dissolution of certain types of gallstones, specifically cholesterol gallstones. Clinical studies have demonstrated that oral bile acids can gradually dissolve small, radiolucent (cholesterol-rich) gallstones in patients with a functioning gallbladder. The mechanism involves reducing cholesterol saturation in bile, thereby promoting gradual stone dissolution. Multiple randomized controlled trials and meta-analyses have shown that UDCA therapy is effective and safe for select patients, especially those who are not suitable candidates for surgery. However, treatment can take months to years, and recurrence of stones is possible after cessation of therapy. Other bile salts, such as chenodeoxycholic acid, have also been used but are associated with higher rates of adverse effects. The use of bile salts is not effective for pigment stones or calcified stones, and is not indicated for patients with acute cholecystitis or complications from gallstones. Guidelines from gastroenterological societies (e.g., American Gastroenterological Association) support the use of UDCA for nonsurgical management in specific patient populations. Therefore, the use of bile salts for gallstone dissolution is supported by substantial scientific evidence, though its application is limited to certain cases.

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