GB sludge + Thickening of GB wall

A 45 year old female had been under treatment with complaints of pain epigastrium especially after meals which last for 3 to 4 hrs ?Biliary colic She also experienced similar episode of pain even after having guava History She is known case of Hypothyroidism on 75mcg L thyroxine Please note she and her family dont take oily,spicy food at all since a very very long time, better to say years Investigations Usg W/A revealed GB Sludge with GB wall thickening Management I have advised her a PPI along with UDCA therpy Tab Udiliv 150mg BD Cap Pantop DSR OD 30mins before breakfast Tab Meftal Spas on SOS basis My concerns are - 1)Is dose of UDCA 150mg BD enough for the patient? Or need to change 2) What else can be advised from pharmacological point of view? I have also advised to get LFT done and see a surgeon if things don't resolve. Please give your expert opinion on this case


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Dear Dr @Ajeet Singh , UDCA to be given 300mg BID to start with & when GB sludge disappear maintenance with 150mg BID. An Hepatoprotective drug like Liv52 or RedlivDS BID. Long duration UDCA usually clears GB sludge without surgical intervention.

After how many days of starting 300mg BD UDCA, I have to repeat the USG W/A ? And how long can I continue UDCA in total ? Like a month or 15 days?

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Ursodeoxycholic acid reduces liver enzymes and hepatoprotective. It works by reducing the amount of cholesterol in the blood and helps in reducing gall bladder stones that composed of mainly cholesterol. We have to remember 5 F ' s in this context, female ,fertile, forty , fat, and fair are the risk factors for development of gall stones. Asymptomatic gall bladder sludge can be managed medically and by diet. Symptomatic and recurrent pain indicates requirement of surgery cholesystectomy.

Life style modifications like exercise Treatment of obesity Detection and treatment of DM, Dyslipedemia UDCA 300 mg OD for a few months. Deworming and a c course of Secnidazole 1gm once daily for 4 days .. Fat free diet

Sir, why deworming?

GB wall thickening points to the acute on chronic cholecystitis. A course of quinolone or 3G cephalosporin is indicated along with UDCA.