Synopsis

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

Cholic acids, specifically in the form of ursodeoxycholic acid (UDCA), are scientifically validated for the treatment of certain types of gallstones, particularly cholesterol gallstones. The mechanism involves the reduction of cholesterol saturation in bile and the gradual dissolution of cholesterol-rich gallstones. Multiple randomized controlled trials and meta-analyses have shown that oral administration of UDCA can effectively dissolve small, radiolucent, non-calcified cholesterol gallstones in patients with a functioning gallbladder. The treatment is not effective for pigment stones or calcified stones, and its use is generally reserved for patients who are not suitable candidates for surgery. The evidence supporting cholic acid derivatives, primarily UDCA, is robust, leading to their approval by regulatory agencies like the FDA for this indication. However, primary cholic acid itself (as opposed to UDCA or chenodeoxycholic acid) is not typically used for gallstone dissolution, and its role is more prominent in the management of certain bile acid synthesis disorders. The majority of clinical guidelines recommend UDCA for specific cases, and its efficacy is well-documented, although the process of gallstone dissolution can take months or years and recurrence is possible after cessation of therapy. In summary, the use of cholic acid derivatives, especially UDCA, for the treatment of cholesterol gallstones is supported by substantial scientific evidence, but not all cholic acids are used for this purpose.

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