[Bile acids in the treatment of cholestatic lesions of the liver].

The authors give an account of their own experience with one-year treatment of primary biliary cirrhosis with ursodeoxycholic acid (Ursofalk). From the investigation ensues: 1. Treatment must be started as soon as possible, best in the first or second stage of PBC (without cirrhotic transformation). In later stages a favourable reaction is rather exceptional and an adverse effect on portal hypertension cannot be ruled out. 2. It is better to start treatment with low doses (250 mg/day) and increase the dose gradually, depending on tolerance. A dose of 500 mg/day usually proves sufficient, but the dose can be raised even to 750 mg/day. 3. During treatment not only clinical improvement is achieved but also a favourable effect on laboratory findings, i.e. cholestatic (ALP and GMT) as well as on the activity of the disease (aminotransferases) is recorded. 4. After discontinuation of the drug and after its prolonged administration and marked improvement a relatively brisk deterioration of clinical and laboratory findings occurs. Therefore treatment must be prolonged. In primary sclerotizing cholangitis hitherto assembled experience is very favourable, but the investigation is too short so far (months). Also proper evaluation of treatment requires a longer follow up period, treatment with ursodeoxycholic acid in the initial stages of primary biliary cirrhosis and in sclerotizing cholangitis is promising. This is important among others because other therapeutic possibilities are so far lacking in this disease.