Can gallstones be treated nonsurgically?

Gall bladder removal surgery, or a cholecystectomy, is the most common form of treatment for gallstones. In some cases, however, gallstones can be treated with medicine. Certain chemicals, such as ursodiol or chenodiol, work to dissolve some gallstones and are available in oral bile acid pills. These pills work to thin out the bile, which allows gallstones to dissolve.

While this medicine can be effective, medical treatment of gallstones is limited to people whose stones are small and made of cholesterol and to those with reoccurring illness if the medication is stopped.

Another procedure, a percutaneous cholecystostomy, can provide temporary relief. A tube is placed through the abdomen and into the gallbladder to drain its contents. It is an option for patients not ready or not strong enough for surgery.

Nonsurgical approaches are used only in special situations-such as when a patient has a serious medical condition preventing surgery-and only for cholesterol stones. Stones commonly recur within five years in patients treated nonsurgically.

Oral dissolution therapy. Drugs made from bile acid are used to dissolve gallstones. The drugs ursodiol (Actigall) and chenodiol (Chenix) work best for small cholesterol stones. Months or years of treatment may be necessary before all the stones dissolve. Both drugs may cause mild diarrhea, and chenodiol may temporarily raise levels of blood cholesterol and the liver enzyme transaminase. Contact dissolution therapy. This experimental procedure involves injecting a drug directly into the gallbladder to dissolve cholesterol stones. The drug-methyl tert-butyl ether-can dissolve some stones in one to three days, but it causes irritation and some complications have been reported. The procedure is being tested in symptomatic patients with small stones.

This answer is based on the source infromation from the National Institute of Diabetes and Digestive and Kidney Diseases. 

Yes, options for nonsurgical treatment of gallstones include:

- Oral drug therapy: Drugs produced from bile acid may dissolve stones.

- Directly injected therapy: A solution may be injected directly into the gallbladder to dissolve the stones.

- Extracorporeal shockwave lithotripsy: A procedure that uses shock waves to break up stones into smaller pieces so they can pass through the bile ducts.

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