Do You Still Need Ursodeoxycholic Acid After Gallbladder Removal?

Medications after cholecystectomy (Ursodeoxycholic Acid)

Dear Director,
My 80-year-old father recently underwent an open surgery to remove a ruptured gallbladder and an abscess.
He is currently recovering gradually after the surgery.
He had been taking Ursodeoxycholic Acid (Ursodiol) twice daily for a long time due to gallstones.
I would like to ask whether it is still necessary for him to continue taking this medication now that his gallbladder has been removed, or if it is no longer needed.
Thank you very much for your assistance amidst your busy schedule.
Wishing you peace and safety.

Ling, 40~49 year old female. Ask Date: 2018/07/30

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, Miss.
While it is possible to refrain from taking medication, some physicians may continue to use it as a preventive measure against the recurrence of bile duct stones.
Changhua Hospital is concerned about your health.
- Chen Shidian

Reply Date: 2018/07/30

More Info

After gallbladder removal, also known as cholecystectomy, the necessity of continuing Ursodeoxycholic Acid (UDCA) therapy largely depends on the underlying reasons for its initial prescription and the patient's current liver and gallbladder function. Ursodeoxycholic Acid is primarily used to dissolve certain types of gallstones and to improve liver function in conditions such as primary biliary cholangitis and cholestasis.
In your father's case, since he had gallstones that led to the removal of his gallbladder, the immediate need for UDCA may be reassessed. The gallbladder's role is to store bile produced by the liver, which aids in the digestion of fats. After its removal, bile flows directly from the liver into the small intestine, which can lead to changes in digestion and absorption of fats. Some patients may experience post-cholecystectomy syndrome, which includes symptoms like diarrhea, bloating, and abdominal pain due to the continuous flow of bile.

If your father was taking UDCA to manage gallstones, the removal of the gallbladder eliminates the need for this medication for that specific purpose. However, if he was using it for liver health or other conditions, it may still be beneficial. It's essential to monitor liver function tests (such as GOT, GPT, and bilirubin levels) to determine if there are ongoing liver issues that might warrant continued use of UDCA.

The potential benefits of continuing UDCA after gallbladder removal include its ability to improve liver function and reduce the risk of liver-related complications. However, if there are no significant liver issues and the gallbladder's removal has resolved the initial problem, it may not be necessary to continue the medication.

Regarding side effects, UDCA is generally well-tolerated, but some patients may experience gastrointestinal symptoms such as diarrhea, constipation, nausea, or abdominal discomfort. If your father experiences any adverse effects or if his liver function tests remain abnormal, it would be prudent to consult with his healthcare provider for a tailored approach.

In conclusion, the decision to continue Ursodeoxycholic Acid after gallbladder removal should be made in consultation with his healthcare provider, considering his overall health, liver function, and any ongoing symptoms. Regular follow-up appointments and liver function tests will help guide this decision. It is crucial to ensure that he receives appropriate care and monitoring during his recovery.

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