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Re: Re: Bile Stones(Dave)

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This was very informative Dave. Thanks for sharing this with the group.

in MO.

Subject: Re: Bile StonesTo: Date: Wednesday, April 8, 2009, 10:11 PM

Hi Sandi;I honestly don't know about how long it would take for stones to form after being taken off of ursodiol, and whether the 7 day period you describe would be enough time. It depends a lot on how big the stones were, and you have not provided any information about that. If they were quite small (like grains of sand), I suppose they could form quite quickly. Did your doctor give you any indications of their size?It's known that when starting on ursodiol for the first time "the proportion of total biliary bile salts comprised by ursodiol increases within 1 to 2 weeks from 1% to a maximum of approximately 60%":http://www.annals. org/cgi/content/ full/121/ 3/207So it is likely that doing the opposite (i.e. being taken off ursodiol) could cause the percent ursodiol in the bile to decrease from 60% to 1% within 1 to 2

weeks.Ursodiol is important for dissolving cholesterol gallstones because it is more hydrophilic (water-loving) than the more hydrophobic (water-fearing) bile salts often accumulated in the bile in cholestatic liver diseases. The cholesterol has a harder time precipitating out of solution in a hydrophilic bile containing ursodiol than in a hydrophobic bile that is deficient in ursodiol. Moreover the cholesterol more readily dissolves in a hydrophilic bile containing ursodiol than in a hydrophobic bile that is deficient in ursodiol.As I mentioned earlier, biliary cholesterol supersaturation is the main problem in gallstone and bile stone formation, and ursodiol therapy also inhibits cholesterol synthesis in the liver, thereby lowering the cholesterol content of the bile. The biliary concentration of cholesterol is probably not closely related to your total serum cholesterol. Thus, biliary concentration of cholesterol could possibly go up

without this showing up in your total serum cholesterol level during the short-term. Best regards,Dave (father of (23)>> Dave,> Hi! Thanks for the explanation. I wasn't actually taken off the Ursodiol until about a week before they found the stones. I'd been on high dose for several years prior to that. Would that lag time be enough time for the stones to form or would they have had to have been there all along? Any idea? Also, they say my cholesterol level is fine. Is this a different type of cholesterol?> Thanks! > Sandi>

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