What To Do About Chronic Cholecystitis With Sandy Gallstones

Chronic cholecystitis accompanied by sandy gallstones can be a challenging condition, but there are effective management strategies available. Depending on the severity of symptoms and complications, treatment options typically fall into two main categories: medication and surgery.

Medication therapy is often the first line of treatment for patients who do not experience significant symptoms such as abdominal pain, fever, or jaundice. In such cases, doctors may prescribe bile acid agents like ursodeoxycholic acid (UDCA, brand name Ursofalk or Actigall) or tauroursodeoxycholic acid (TUDCA, brand name Taurox). These medications can help dissolve small cholesterol-based stones and reduce inflammation in the gallbladder. Sometimes, they may be combined with other bile acids like chenodeoxycholic acid for enhanced effectiveness.

However, if symptoms become severe or frequent, such as recurring episodes of intense abdominal pain, or if complications like cholangitis, common bile duct stones, or pancreatitis arise, surgical intervention may be necessary. In these situations, a consultation with a specialist is crucial to determine if cholecystectomy — the surgical removal of the gallbladder — is the best course of action.

Patients undergoing medical dissolution therapy with UDCA or similar drugs are generally advised to continue treatment for a minimum of six months and up to 24 months. During acute pain episodes, medication should be temporarily discontinued. Additionally, it's important to maintain a low-fat diet to avoid triggering gallbladder attacks.

Regular monitoring is a key part of managing this condition. It is recommended to undergo ultrasound examinations every three months to track any changes in the size or number of gallstones, assess gallbladder wall thickness, and monitor for signs of worsening cholecystitis or other complications.

By following a structured treatment plan and staying under medical supervision, individuals with chronic cholecystitis and sandy gallstones can effectively manage their condition and reduce the risk of serious complications.