Dissolution of Gallstones

Key facts

• Gallstones are hardened deposits that form in the gallbladder, most often made mainly of excess cholesterol in bile.
• Surgery to remove the gallbladder is usually the first choice, but dissolution therapy is a non-surgical alternative for small, cholesterol-based stones.
• The main medicine is ursodeoxycholic acid, which reduces the cholesterol the liver secretes into bile so existing stones gradually break down.
• Severe right-sided abdominal pain, fever, or yellowing of the skin or eyes needs prompt medical assessment rather than waiting for treatment to work.

What dissolution therapy is

Gallstones form when bile holds more cholesterol than it can keep dissolved, so the excess crystallises into hard deposits inside the gallbladder. Removing the gallbladder surgically is the standard fix, but it is not the right choice for everyone. People with small, non-calcified, cholesterol-based stones who are unfit for an operation, or who would rather avoid one, can consider dissolving the stones with medicine instead.

How bile acid therapy works

Ursodeoxycholic acid is a naturally occurring bile acid that lowers the amount of cholesterol the liver puts into bile. Over time this shifts bile away from a cholesterol-saturated state that builds stones and toward one that gradually dissolves the crystals already there. Treatment usually runs for several months and works best on small stones that have not calcified. It sits alongside broader digestive health management: diet and lifestyle changes matter too, because stones can return once therapy stops if the underlying cause, typically excess cholesterol in bile, is not addressed.

When to see a doctor

Severe pain in the upper right abdomen, fever, or jaundice can signal a blocked bile duct or an infected gallbladder, both of which need same-day medical care rather than dissolution therapy. A routine review with a doctor also confirms that your stones are a good match for this approach before you start it.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.