Postcholecystectomy syndrome (PCES) is not the most common phenomenon in gastroenterology. It is generally accepted that PCES belongs to the group of gallbladder diseases. In fact, this is not even a disease, but a collective name for a set of symptoms that appear immediately or shortly after surgery on the bile ducts or removal (resection) of the gallbladder.
Until now, both therapists and surgeons find it difficult to clearly determine the causes of the development of this syndrome. Doctors tend to use the term PCES only to make a preliminary diagnosis in operated patients1.
Pharmacological properties of the drug Ursosan
Ursodeoxycholic acid has a membrane-stabilizing and hepatoprotective effect, protecting hepatocytes from damaging factors. It has immunomodulatory activity, reduces the severity of immunopathological reactions in the liver by reducing the expression of histocompatibility antigens HLA-1 on hepatocytes and HLA-2 on bile duct cells and reducing the effect of immunoglobulins (primarily IgM). Reduces the formation of cytotoxic T-lymphocytes. By stimulating exocytosis in hepatocytes during cholestasis by activating Ca2+-dependent α-protein kinase, ursodeoxycholic acid reduces the concentration of bile acids toxic to hepatocytes (cholic, lithocholic, deoxycholic, etc.). Inhibits the absorption of lipophilic bile acids in the intestine (apparently due to a competitive mechanism), increases their fractional turnover during the hepatic-intestinal circulation; induces choleresis with a high content of bicarbonates, which leads to an increase in the passage of bile and stimulates the excretion of toxic bile acids through the intestines. By replacing non-polar bile acids, it forms non-toxic mixed micelles. By reducing the synthesis of cholesterol in the liver, as well as its absorption in the intestine, ursodeoxycholic acid reduces the lithogenicity of bile, reduces the cholate-cholesterol index, promotes the dissolution of cholesterol stones and prevents the formation of new ones. Absorbed in the small intestine by passive diffusion, and in the ileum by active transport. The maximum concentration in the blood plasma after oral administration is reached after 0.5–1 hour. 96–99% binds to blood plasma proteins. The therapeutic effect of the drug depends on the concentration of ursodeoxycholic acid in bile. About 50–70% of the total dose of the drug is excreted in the bile. In the intestine, it is partially broken down to lithocholic acid, which, during enterohepatogenic circulation, enters the liver and is retransformed into cheno- and ursodeoxycholic acids.
Ursosan for gallstones
The benefit of the drug in the fight against gallstone diseases is explained by the fact that the components of the drug stimulate the synthesis of secretions and their removal from the digestive system. These processes improve the quality of bile and allow you to quickly cope with congestion in the body. Here are reviews from patients taking Ursosan for gallstones. There are both positive and negative reviews.
Oleg , 53 years old
At the appointment, the doctor discovered 3 small gallstones in me. This problem did not bother me, but the gastroenterologist said that they could increase in size and block the bile ducts. To prevent complications, the specialist prescribed Urososan at a dosage of 250 mg 3 times a day. I can’t say that the drug helped me, because before that I didn’t experience any health problems. But now I will constantly take it to avoid consequences in the future. I recommend that everyone follow a simple diet during treatment: give up fatty and smoked foods. Otherwise, even the most effective drug will be useless.
Rimma , 38 years old
Ursosan is the worst drug I have taken in recent years. The doctor prescribed it to me because of thickening of bile. He said that if timely measures are not taken, gallstones may form. The drug was prescribed to me for 4 months, but after a month of taking it I felt terrible nausea and problems with bowel movements. In addition to side effects, Urososan has another significant drawback - high cost. People who will be forced to take it in courses will have to splurge on the medicine. Instead of Urososan, I take natural medications with a choleretic effect.
Use of the drug Ursosan
To dissolve gallstones, as well as in the treatment of acute and chronic liver diseases, Ursosan is used at a dose of 10 mg/kg per day without interruption for a long time.
Body weight, kg | Ursodeoxycholic acid, mg | Number of capsules |
| Up to 60 | 500 | 2 |
| 60-80 | 750 | 3 |
| 81-100 | 1000 | 4 |
| Over 100 | 1250 | 5 |
The duration of taking Ursosan to dissolve cholesterol gallstones ranges from 6 months to 2 years. If after 12 months from the start of taking Ursosan there is no reduction in gallstones, it is not advisable to continue treatment. When treating biliary reflux gastritis, the drug is prescribed 250 mg once a day before bedtime. The duration of treatment is usually 10–14 days. When treating cholestatic syndrome for different types of liver damage, the daily dose depends on the patient’s body weight. Usually this is 8–12 mg of ursodeoxycholic acid per 1 kg/day, that is, 500–700 mg (2–4 capsules).
Body weight, kg | Daily dose, mg | In the morning | During the day | In the evening |
| Up to 60 | 500 (2 capsules) | 1 | 1 | |
| 60–80 | 750 (3 capsules) | 1 | 1 | 1 |
| 81–100 | 1000 (4 capsules) | 1 | 1 | 2 |
The maximum daily dose is 1500 mg (6 capsules). The duration of treatment for chronic liver diseases can range from several months to 2 years. For children over 3 years of age, dosage is individual - it is recommended to prescribe 10–20 mg/kg/day. The capsules are swallowed without chewing, washed down with a sufficient amount of water.
Ursosan for polyps in the gallbladder
So far, no effective medications have been developed that can eliminate gallbladder polyps. The shape of the neoplasms resembles thin papillae on a stalk. They belong to the group of benign growths that do not threaten human life. However, polyps can grow in size and make it difficult to digest food.
Polyps can only be treated surgically. The main goal of drug treatment is to eliminate the unpleasant symptoms of indigestion and prevent the occurrence of new growths. Ursosan is an effective remedy that normalizes digestion against the background of the problem.
Polyps make it difficult for bile to flow out of the bladder. Ursosan dilutes bile and prevents its stagnation in the body. For gall bladder polyps, a drug with hepatoprotective properties is taken three times a day. Here are reviews from patients taking Ursosan for polyps in the gallbladder.
Victoria , 47 years old
I discovered a polyp in the gallbladder by accident. Before this, I suffered from heaviness in my right side and bloating after eating. For a long time I suffered from skin allergies, which I treated unsuccessfully at the dermatologist. On an ultrasound, the gastroenterologist discovered 2 large polyps in my gallbladder (0.2 and 0.4 cm in size). The organ was 1/3 filled with stones and sand.
The doctor prescribed me a drug with urodeoxycholic acid - Ursosan at a dosage of 500 mg in the morning and 1000 mg at night. In addition to it, the gastroenterologist advised drinking Odeston. The treatment lasted 3 months. At my second appointment, the doctor noticed positive changes in me - the sand and stones were almost completely removed from the gallbladder, the polyps did not increase in size.
After completing the course, I began to feel much better, and my digestive problems partially disappeared. I think that if I regularly take Urososan courses, I will be able to avoid surgical intervention.
Tatyana , 52 years old
Gallbladder polyps are a common disease that affects most people over 40 years of age. I don't think drugs can help people solve this problem. Many people live with polyps for 10, 20 or more years without taking any medications. Modern medicine offers minimally invasive methods of intervention (through a puncture in the abdominal cavity), after which the patient can quickly recover and return to their normal lifestyle.
Special instructions for the use of the drug Ursosan
Successful conservative treatment of cholelithiasis is possible in the presence of purely cholesterol (X-ray negative) stones with a diameter of no more than 2 cm, preserved gallbladder function; stones should not fill more than half the volume of the gallbladder. During long-term treatment (more than a month), periodically, once a month, it is necessary to determine the activity of liver transaminases, especially in the first 3 months of treatment. Unlike chenodeoxycholic acid, the embryotoxicity of ursodeoxycholic acid has not been proven. Therefore, the decision to use Ursosan during pregnancy is made by the doctor. The use of Ursosan during breastfeeding is recommended only in case of urgent need.
Treatment of postcholicystectomy syndrome
Since PCES is not an independent disease, treatment of the syndrome is always determined by its causes. Not knowing how to properly treat postcholicystectomy syndrome can only aggravate the condition and increase unpleasant symptoms.
The principles of treatment for PCES include two key points:
- collection of anamnesis data - the doctor carefully studies old medical reports and records, paying close attention to preoperative diagnostics and the protocol of the operation;
- eliminating the causes of the syndrome;
- prevention and treatment of suspected complications.
Treatment is mainly based on:
- diet therapy;
- drug treatment;
- surgery (according to indications)7.
Together with comprehensive treatment, these measures can reduce the severity of symptoms of PCES8.
Ursosan for hepatitis
The complex action of Ursosan allows it to be used for various types of hepatitis. The drug is prescribed only as part of complex therapy for the disorder. Only using it will not solve the problem. Chronic forms of hepatitis require long-term medication. Urosdeoxycholic acid is a safe drug that is not addictive to the body. For this reason, it can be used throughout the course of hepatitis treatment in large dosages.
Anastasia , 39 years old
The doctor prescribed Urososan to relieve the symptoms of hepatitis C. After taking the drug, I stopped suffering from itchy skin. The medicine helps me sleep normally.
Veronica , 41 years old
A year ago I was diagnosed with hepatitis C. The doctor prescribed a diet and medication. Among the recommended drugs I would like to mention Ursosan. He helped me reduce pain in the right hypochondrium and normalize digestion. The doctor said to take the medicine at night, because the drug is better absorbed at this time of day. Now I take pills after overeating to reduce the load on the diseased organ.
Ursosan for cholecystitis
Cholecystitis is a disorder manifested by inflammation of the gallbladder tissue and changes in the qualitative composition of bile. Pathology contributes to stagnation of secretions in the body and the appearance of digestive problems. Untimely treatment of cholecystitis threatens the development of cholelithiasis.
Larisa , 33 years old
I bought Ursosan for the treatment of cholestasis. I thought that an expensive drug would finally help me cope with the problem. I observed positive changes in myself after the course of therapy: heaviness in the area of the right rib disappeared, stool returned to normal. I was very disappointed when, after stopping treatment, my previous problems returned. The second time I drank Ursosan for a long time (about 4 months) in the hope that during this time positive changes would occur in the body. But I felt better only during treatment. I don’t see the point in giving that kind of money to mask the symptoms of the disease.
Rinata , 24 years old
I felt problems with my liver after taking antibiotics. I felt very strong pain on the right side and consulted a doctor. He said that I had acute cholecystitis and prescribed Ursosan to drink. The drug quickly relieved me of discomfort and pain. Now I take it every time after antibiotic therapy.
Ursosan for fatty hepatosis
The disease is triggered by active deposition of fat in hepocytes (liver cells). Untimely treatment of the pathology can lead to the development of an incurable disease – cirrhosis of the liver. Urososan allows you to cope with the problem due to its hypolepidemic properties. It reduces the amount of lipids in the blood due to which healthy liver cells stop being replaced by fatty ones. Let's get acquainted with the reviews of people who took Ursosan for fatty hepatosis.
Alena , 43 years old
I treated fatty hepatosis comprehensively: with medications and diets. I took courses of Ursosan and other drugs that improve metabolism and prevent stagnation in the body. I had to give up carbohydrates, fats and alcohol. Additionally, she changed her lifestyle. I began to move more and walk in the fresh air. I think that this is the only way to overcome fatty hepatosis.
Stepan , 37 years old
I have been suffering from liver problems for a long time and have tried many medications. 3 years ago I was diagnosed with fatty hepatosis. To prevent complications, I regularly take Ursosan. This drug has a proven clinical effect in the fight against numerous gastrointestinal pathologies. However, I do not recommend anyone to take it without a prescription. Ursosan, like any other medicine, has its indications and contraindications.
Ursosan for neonatal jaundice
Ursosan accelerates the flow of bile from the body and normalizes liver function. For this reason, it is often prescribed to newborn children with jaundice. Additionally, the drug has an immunomodulatory effect, helping the child’s body cope with additional stress. Here are reviews from mothers who gave Ursosan for newborn jaundice.
Tatyana , 23 years old
After birth, my child’s bilirubin increased to 253. I did everything that the pediatrician recommended, but my daughter showed no improvement. I gave her glucose and Ursosan 1/6 tablet. It was difficult to divide the tablet according to the dosage. As a result, we were sent to the hospital for intensive care. We spent 5 days in the hospital. When we were discharged, bilirubin dropped to 100. The doctor said that Ursosan was not suitable for our age.
Polina , 31 years old
The child's jaundice was treated with Ursosan. In combination with Galstena it gave good results. The yellowing of the skin and sclera of the eyes disappeared after 2-3 weeks.
