Abstract
Cholesterol gallstones form frequently among obese patients during rapid loss of weight. The aims of the present study were to determine the short-term natural history of these gallstones and the efficacy of ursodiol for their dissolution. Twenty-two patients whose gallstones had formed during rapid loss of weight were randomized in double-masked fashion to either ursodiol, 1200 mg/day, or placebo for nine months. Ultrasonography of the gallbladder was performed after three and nine months of treatment. All patients without disappearance of their gallstones after nine months received open-label ursodiol for an additional nine months with ultrasonography after three and nine months. Among the patients completing three months of masked treatment, disappearance of gallstones was seen in five of 11 patients who received placebo and four of seven patients who received ursodiol. Only one additional patient of six continuing placebo for nine months experienced disappearance. Neither of two patients continuing ursodiol for nine months had disappearance of gallstones. None of the five patients treated with open-label ursodiol for nine months had disappearance of gallstones. Thus, half of the gallstones that form during rapid loss of weight disappear rapidly once loss of weight ceases; ursodiol may not increase the frequency or rapidity of their disappearance.
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Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ, Marks JW: Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight. N Engl J Med 319:1567–1572, 1988
Liddle RA, Goldstein RB, Saxton J: Gallstone formation during weight reduction dieting. Arch Intern Med 149:1750–1753, 1989
Shiffman ML, Sugarman HJ, Kellum JM, Brewer WH, Moore EW: Gallstone formation after rapid weight loss: A prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol 86:1000–1005, 1991
Yang H, Petersen GM, Roth M, Schoenfield LJ, Marks JW: Risk factors for gallstone formation during rapid loss of weight. Dig Dis Sci 37:912–918, 1992
Schoenfield LJ, Lachin JM: Chenodiol (chenodeoxycholic acid) for dissolution of gallstones: The National Cooperative Gallstone Study. A controlled trial of efficacy and safety. Ann Intern Med 95:256, 1981
Podda M, Zuin M, Battezzati PM, Ghezzi C, DeFazio C, Dioguardi ML: Efficacy and safety or a combination of chenodeoxycholic acid and ursodeoxycholic acid for gallstone dissolution: A comparison with ursodeoxycholic acid alone. Gastroenterology 96:222–229, 1989
Walters JRF, Hood KA, Gleeson D, Ellul JPM, Keightley A, Murphy GM, Dowling RH: Combination therapy with ursodeoxycholic and chenodeoxycholic acids: Pretreatment computed tomography of the gallbladder improves gallstone dissolution efficacy. Gut 33:375–380, 1992
Wattchow DA, Hall JC, Whiting MJ, Bradley B, Iannos J, Watts J McK: Prevalence and treatment of gallstones after gastric bypass surgery for morbid obesity. Br Med J 286:763, 1983
Bennion LJ, Grundy SM: Effects of obesity and calorie intake on biliary lipid metabolism in man. J Clin Invest 56:996–1011, 1975
Whiting MJ, Jarvineu V, Watts JM: Chemical composition of gallstones resistant to dissolution therapy with chenodeoxycholic acid. Gut 21:1077–1081, 1980
Maton PN, Murphy GM, Dowling RH: Lack of response to chenodeoxycholic acid in obese and non-obese patients. Gut 21:1082–1086, 1980
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This project was supported by the National Institute of Diabetes, Digestive and Kidney Diseases, grant AM 37080, and Ciba-Geigy Corporation.
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Marks, J.W., Stein, T. & Schoenfield, L.J. Natural history and treatment with ursodiol of gallstones formed during rapid loss of weight in man. Digest Dis Sci 39, 1981–1984 (1994). https://doi.org/10.1007/BF02088135
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DOI: https://doi.org/10.1007/BF02088135