Primary prevention

Although the evidence for a preventative effect is weak, lifestyle modification remains the cornerstone of primary prevention of gallstones. Preventative lifestyle modifications recommended in practice include a diet high in fiber, protein, calcium, and vitamin C and low in saturated fat, and maintenance of a healthy body weight, combined with moderate physical activity.[1][2][7][27][61][64][65][66][67]

Preventative medical therapy with ursodiol, which lowers cholesterol saturation in bile, can be used to reduce the short-term risk of stone formation in obese individuals undergoing rapid weight loss through dietary caloric restriction or weight loss surgery.[68] In those undergoing surgery, ursodiol has only been shown to be effective when used preoperatively.[68] In this setting, ursodiol should only be used until the patient’s weight has stabilized, as the evidence for its efficacy is limited.[1][69] Ursodiol has limited value for dissolving established gallstones and is not recommended for any other patient groups.[70]

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