Ursodeoxycholic acid in biliary pathology: current concepts
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 2
Abstract
Ursodeoxycholic acid (UDCA) is a drug commonly used in clinical practice. This article is devoted to a review of research of the possibility of using UDCA for biliary system diseases. Prevention of the formation and dissolution of gallstones is one of the first and main indications for administration of UDCA. This was the beginning of the era of this amazing pleiotropic molecule in the 80s of the last century. UDCA preparations are based on chemical synthesis, but they have a natural origin and have a complex effect at the level of the organism as a whole. The therapeutic effect of UDCA is directed at once to several pathogenetic links that normalize human metabolism. This allows to avoid polypragmasy of medical prescriptions and is important not only in terms of the efficacy and safety of the treatment, but also in optimizing the economic costs of purchasing medicines for patients with comorbid pathology, often the elderly. The article briefly presents epidemiology of gallstone disease, clinical manifestations, features of changes in the composition of bile during development of cholelithiasis. The characteristic of the UDCA molecule by the mechanism of action is presented. The advantages of UDCA compared with medicinal herbs and herb-based preparations; in particular, safety of use and the pleiotropic nature of the UDCA molecule, are discussed, as well as its role in normalization of metabolic processes in the human body, especially lipid metabolism. Dysfunctional disorders of the biliary tract, biliary sludge and cholelithiasis are considered in detail. Attention is paid to formation of gallstones against the background of genetic mutations (mutations in the gene encoding the phosphatidylcholine flopase ABCB4; mutations of the UGT1A1 gene responsible for development of the Gilbert’s disease or Gilbert’s syndrome). The recommended doses and mode of administration of UDCA in these indications are indicated according to modern clinical concepts. The accumulated successful experience in their conservative treatment with the help of UDCA instills optimism in achieving positive results in the form of normalization of biliary motility, elimination of biliary insufficiency, elimination of biliary sludge, primary prevention and treatment of gallstone disease.
Authors and Affiliations
M. B. Shcherbynina
Keywords
Related Articles
- EP ID EP575027
- DOI 10.30978/MG-2019-2-46
- Views 118
- Downloads 0
Drug-induced liver damage in the onco-hematology patients: the assessment of the efficacy of sublingual ademetionine formulation
The authors presented the modern views on the mechanism of development, risk factors and treatment of the drug-inducedchronic hepatitis. The analysis has been performed for the efficacy of sublingual ademetionine formula...
United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis
-
Effects of L-ornithine-L-aspartate on the manifestation of minimal hepatic encephalopathy in the dynamics of cytostatic therapy
Objective — to investigate effects of the L-ornithine-L-aspartate (LOLA, Hepa-Merz®) on the clinical manifestations of minimal hepatic encephalopathy (HE) in patients with multiple myeloma (MM) in the dynamics of cytosta...
The new possibilities for the treatment of patients with chronic constipation
Objective — to analyze the efficacy of using the herbal drug EasyDo in patients with chronic constipation. Materials and methods. The observations involved 40 patients with chronic constipation, aged 18 to 65 years, who...
Clinical Practice Guidelines of European Association for the Study of the Liver (EASL) on nutrition in chronic liver disease. Part 2
-