6 best choleretic drugs

*Overview of the best according to the editors of Healthy Food Near Me. About selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.

Cholagogue preparations are necessary for the full digestion of food, first of all, for patients with pathology of the gallbladder, biliary tract, pancreas. However, not all pathologies of the biliary tract and gallbladder may require choleretic drugs. For example, with an inflection of the neck of the gallbladder, which is clearly visible on ultrasound, cholagogues are contraindicated. After all, if there is an inflection, accordingly, there will be a difficulty in the outflow of bile into the duodenum. And if, on the contrary, you start stimulating bile secretion, then you can get overstretching of the gallbladder, pain syndrome, and an emergency condition that can result in an operation in a surgical hospital. Therefore, it is by no means possible to independently prescribe and take choleretic drugs to oneself, no matter how harmless they may seem.

Why is bile needed?

And now, after this warning, let’s talk a little about the bile itself. Why stimulate its formation or excretion? Why is she needed? First of all, you need to remember that the main pigment of bile is bilirubin, which is formed from constantly decaying red blood cells that live on average 4 months and have outlived their lives. Human nature has mastered zero-waste technologies to perfection, and instead of simply utilizing hemoglobin that has become unnecessary, it turns it into bilirubin, which, together with bile acids, forms bile.

Bile is produced by liver cells, or hepatocytes. Bile is produced constantly, both day and night, then it enters the bile ducts, which are connected to the common duct, and enter the gallbladder. Many people think that the gallbladder is just a reservoir for storing bile, which is then released into the duodenum during digestion. Actually this is not true. The gallbladder is an organ that absorbs water into its walls, so the bile is concentrated and becomes more active.

The flow of bile into the duodenum is regulated by complex conditioned reflexes and humoral factors, for example, through the influence of pancreozymin-cholecystokinin secreted by the duodenal mucosa. Bile works in the intestines, its function is to emulsify fats: without the presence of bile, fats cannot be digested. After bile has left the duodenum, it is absorbed along with nutrients in the small intestine, and the remaining bile, approximately 30%, leaves the body with feces. Bile is made up of bile acids, phospholipids, proteins, cholesterol, and bilirubin. In addition to facilitating the absorption of fats, bile that has penetrated into the intestine slows down the synthesis of endogenous cholesterol, and the body mainly receives cholesterol from food. As soon as there is no bile (and cholesterol) in the intestine, the synthesis of endogenous cholesterol starts again by the negative feedback mechanism.

An extremely important function of bile is its assistance in the absorption of fat-soluble vitamins. This is vitamin D, which regulates phosphorus-calcium metabolism, vitamin K, which takes part in blood clotting, as well as vitamins A and E. If a person has poor bile secretion, then pancreatic enzymes that break down fats also work poorly. For example, pancreatic lipase. Therefore, if a person is poorly separated or little bile is produced, then he develops intolerance to fatty foods, feces contain undigested, neutral fat, which irritates the walls of the large intestine and often leads to chronic diarrhea.

There is even the phenomenon of steatorrhea, in which the feces are so greasy that they are not washed off with water, and leave marks on the walls of the toilet. Therefore, if you often have to use a brush to clean the toilet, because there is not enough water, think about whether you are shown choleretic drugs, and do you have a deficiency of pancreatic enzymes?

Cholekinetics, choleretics, cholespasmolytics…

There are many diseases and pathological conditions in which the formation or excretion of bile is impaired. These are various chronic liver diseases, chronic hepatitis, including alcoholic, autoimmune liver damage, biliary dyskinesia, inflammatory chronic diseases of the gallbladder, such as chronic cholecystitis, cholelithiasis.

There is such a phenomenon as an increase in the lithogenicity of bile, that is, an increase in the ability of bile to form stones. There are two large groups of choleretic agents. The first group enhances the formation of bile, these are choleretic choleretics. The second group of drugs are drugs that accelerate the excretion of bile, that is, cholekinetics. But such a division can be considered rather arbitrary, and is of interest only for theoretical pharmacology. After all, most choleretic drugs affect both the secretion of bile and its motility.

We will not talk in detail about the mechanisms of action of cholekinetics and choleretics, we will only say that drugs that increase the synthesis of bile increase the osmotic gradient between the media section: bile and blood. This enhances the penetration of electrolytes and water into the bile capillaries, and the bile flow is accelerated. Such drugs reduce the risk of cholesterol precipitation, that is, they prevent the appearance of gallstones, improve digestion in the small intestine, and stimulate its motility.

As for drugs that promote the excretion of bile, they affect the muscles of the gallbladder, and are called pure cholekinetics, since when they are used, the gallbladder contracts and bile is released into the intestines. However, it is possible to promote the release of bile in a completely opposite way: no longer by contracting the muscles, but, on the contrary, by relaxing the muscles of the sphincter of Oddi and the biliary tract. Such drugs are called cholespasmolytics, and they are needed for spastic conditions of smooth muscles.

It seems incredible that bile aids digestion. After all, if you taste medical bile, you can be sure that it tastes terribly bitter. But it is precisely such bitter bile that has a very good effect on digestion, normalizes motility and absorption, affects plastic metabolism and improves anabolic processes.

Before we talk about a small number of effective choleretic agents, let’s think about the symptoms that may indicate difficulty in digestion in the small intestine, and jaundice, which can develop if bile does not drain. First of all, it is bloating and discomfort in the abdomen, a feeling of heaviness in the stomach after eating, belching rotten, bitter, a sharp intolerance to certain types of food, most often fatty.

In some cases, with difficulty in the formation of bile, the phenomenon of jaundice may occur, in which case it is urgent to be examined by a doctor. After all, jaundice can be of three types: and only in the last, mechanical case, we are talking about the fact that the resulting bile cannot penetrate the intestines, and therefore is absorbed into the blood. The most common cause is gallstone disease, a stone that blocks the common bile duct, or a malignant tumor that compresses it.

However, jaundice can also develop for other reasons. For example, in case of infection with acute viral hepatitis, due to the manifestation of the clinic of alcoholic cirrhosis of the liver, or liver cancer in the later stages. With the development of the clinic of jaundice, the sclera, the frenulum of the tongue first turn yellow, darkening of the urine and discoloration of the feces appear. How can you be sure that dark urine is really caused by jaundice? Very simple. Such urine in a person with jaundice will, when dried, leave yellow spots on bedding. And in a healthy person, even if he has bright yellow urine, when it dries on a white cloth, there will be no bright yellow and sharply limited spots. So, let’s move on to a description of some popular choleretic drugs and their action.

The best choleretic drugs

Modern choleretic drugs

Before starting a story about choleretic drugs, which, indeed, have been created a little, and their number cannot be compared, for example, with antibiotics, let’s recall the general rules of drug reviews. First, for each drug, INN, the international non-proprietary name, that is, the chemical structure, substance, name of the chemical, will be given.

Next, the name of the original drug will be given, which was first introduced to the market, was the flagship in the line of these medicines. The original drug should always be trusted. Although it is more expensive, it always has the purest substance from which it is made. This original remedy has the largest number of different scientific studies on its effectiveness, safety, and drug interactions with other drugs.

Further, if there are commercial copies of this tool, or generics produced by other companies will be named. Generic drugs are always cheaper, the chemical substance from which these drugs are made is usually simpler. If you need to save money, then it is still advisable to purchase the so-called branded generics, which have their own name and are produced either in Eastern Europe or in India. The quality of modern Indian medicines is on top, as well as medicines from Eastern Europe. Unless absolutely necessary, we advise you not to purchase the cheapest medicines, since no one can vouch for their effectiveness, so that it is comparable to the original drug.

In some cases, there may be neither an international generic name nor an originator drug. This may be the case if we are talking about herbal medicinal raw materials, and just among the choleretic drugs there are quite a lot of herbal medicines. The following will be the price range relevant for pharmacies of all forms of ownership in the Russian Federation for March-April 2020. In this review, some tools, of course, are not included. We do not advertise any manufacturer or drug, and we do not make anti-advertising without including any product in the review. It includes those drugs that exist in the national and clinical recommendations of gastroenterologists for the treatment of biliary dyskinesia, chronic cholecystitis and pancreatitis, and which can be freely bought in pharmacies without a prescription.

Ursodeoxycholic acid (Ursosan, Grinterol, Urdoksa, Ursoliv, Ursofalk, Urtsevel, Exhol)

Rating: 4.9

The first of the choleretic drugs, let’s consider a serious remedy – ursodeoxycholic acid. The most expensive drug on the Russian market is Ursosan, Czech-made. One hundred capsules of 250 mg will cost, on average, 1600 rubles. Surprisingly, despite such serious indications, ursodeoxycholic acid can be considered one of the main components of bile. That is why you can count on Ursosan as a choleretic.

It has a hepatoprotective and choleretic effect, dissolves stones, reduces the level of lipids and cholesterol in the blood plasma, and even exhibits an immunomodulatory effect. It is indicated for use if the patient has cholelithiasis, but not complicated, and there is no blockage of the gallbladder ducts or common bile duct by a gallstone.

Ursosan is prescribed in the event that it is impossible to remove stones from the gallbladder surgically, but it is known that they consist of cholesterol, since ursodeoxycholic acid is able to dissolve these stones. Also, this remedy is indicated for active forms of chronic hepatitis, and, above all, viral. Ursosan is prescribed as a prophylactic after removal of the gallbladder, so that stones do not form again. Other indications for use are toxic alcoholic liver disease, primary biliary cirrhosis, cystic fibrosis of the liver, congenital atresia of the intrahepatic tract and bile duct, biliary dyskinesia, reflux gastritis, and reflux esophagitis of bile, and even the prevention of liver damage with long-term treatment with cytostatics and combined hormonal contraceptives.

It is necessary to apply this medicine two to three times a day, usually at a dosage of 10 to 15 mg per kilogram of body weight, which for the average person is up to 5 capsules per day. In the case of gallstone disease, the entire dose must be taken immediately at night. In this case, the drug will be taken for a long time: until the stones dissolve completely, and then Ursosan should be used for another 3 months as a means of prevention. Perhaps the smallest effective dose of Ursosan is used in the case of biliary reflux esophagitis, just one capsule per day, at bedtime. With reflux gastritis and reflux esophagitis, the course of treatment is quite long, in some cases up to six months, and sometimes up to 2 years. If we are talking about alcoholic liver damage, then a dose of 15 mg per kg of body weight is taken in 2-3 doses, the duration of treatment is up to a year. There are dosages in the case of primary sclerosing cholangitis, cystic fibrosis. They are determined by the doctor.

Advantages and disadvantages

As can be seen from the indications, bile acid preparations are prescribed for very serious and serious diseases, and not just for mild dyspeptic syndromes associated with abdominal discomfort or stool disorders. However, they also have corresponding disadvantages. Do not use Ursosan in case of detection of gallstones consisting not of cholesterol, but of calcium, that is, visible on the X-ray. This remedy is not used if the gallbladder does not function and is turned off from the circulation of bile. You can not appoint it in case of blockage, or obstruction of the biliary tract, for example, in case of invasion by opisthorchs. In acute processes, and purulent formations of the gallbladder, Ursosan is also contraindicated. Therefore, in acute cholecystitis and cholangitis, it cannot be used. It should not be used in children under two years of age, but only for a purely mechanical reason: difficulty swallowing capsules. In pregnant women, the drug should be taken with caution. There are also side effects. Usually this is back pain, diarrhea, or an increase in liver transaminases: ALT and AST. While taking Ursosan, it must be remembered that antacids that reduce the acidity of gastric juice also reduce the absorption of this drug and, as a result, reduce its effectiveness.

Pumpkin

Rating: 4.8

Tykveol is just an example of a drug that, although it has its own commercial name, is not an original remedy, it is a highly purified natural raw material. What is Tykveol made of? These are biologically active substances isolated from pumpkin seeds: various phospholipids, tocopherol, polyunsaturated fatty acids, carotenoids. The drug is sold both in the form of capsules, weighing 450 mg, and in the form of oil, in vials for oral administration of 100 milliliters. Tykveol is also sold in the form of rectal suppositories or suppositories. In this case, cocoa butter is additionally added as a base. By itself, the drug looks like an oil, like a greenish-brown liquid, it has a pleasant smell and taste, and the capsules, of course, do not smell of anything, because they are made of gelatin, but they have the same oil inside. We are naturally interested in the oral dosage form, that is, in the form of capsules.

The substances isolated from pumpkin seeds are able to eliminate oxidative stress, and therefore Tykveol has a hepatoprotective effect. It is based on the inhibition of lipid peroxidation, and a decrease in the concentration of reactive oxygen species, primarily superoxide anion. It is he who has a damaging effect, and induces apoptosis of hepatocytes, that is, “turns on” programmed cell death. As a result of taking Tykveol, hepatocyte membranes are restored, intercellular metabolism improves, and the synthesis of fibroblasts, that is, connective tissue, slows down. It is the excess fibrosis that underlies the development of cirrhosis of the liver. Regular intake of Tykveol accelerates the regeneration of the hepatic parenchyma, that is, it allows you to slow down the process leading to the appearance of chronic liver failure. The drug produces a choleretic effect, improves the chemical composition of bile and reduces the risk of gallstones. Along the way, phospholipids isolated from pumpkin seeds help restore the structure of hepatocyte cell membranes and normalize its permeability.

The drug is indicated for biliary dyskinesia, liver cirrhosis, alcoholic disease and fatty degeneration, chronic hepatitis, and cholecystocholangitis. Since the drug is able to reduce the concentration of “bad cholesterol”, Tykveol can be used to prevent atherosclerosis, with certain types of hyperlipidemia, and even with prostate hyperplasia and hemorrhoids in suppositories.

Tykveol in the form of oil, topically, is used for various skin diseases, burns, for treating the cervix in gynecology, for stomatitis and gingivitis. Tykveol capsules should be taken 4 pieces after meals 3 to 4 times a day. The duration of the course of treatment is 3 months. With diffuse liver damage, chronic cholecystitis and dyskinesia, the duration of treatment may be shorter, but most importantly, it should not be shorter than 3 weeks.

Advantages and disadvantages

Produces Tykveol domestic pharmaceutical company Europe. The cost of a package of 50 capsules of 450 mg is from 250 to 520 rubles. The great advantage of Tykveol is its release in various forms, which allows it to be used not only in the pathology of the gastrointestinal tract, but also for the treatment of wounds, in gynecology, and in urology. The drug has very few contraindications: it is peptic ulcer of the stomach and duodenum in the acute stage, cholelithiasis, and children under 12 years of age. Also, Tykveol has practically no side effects, of which only an increase in stool is indicated, and then while maintaining its normal consistency, that is, diarrhea does not develop on Tykveol. The disadvantage is the fact that Tykveol belongs to food additives. And everyone knows that they cannot cope with severe pathology on their own, and their place is determined only in complex treatment.

Allochol

Rating: 4.7

Allochol can be called the most popular and affordable “folk” choleretic medicine. This is a combined remedy, and Allohol contains dry bile of cattle (cattle), dry nettle and garlic, as well as activated charcoal. All these components together give a stronger choleretic effect than just one bile. Allochol is able to increase contractions (peristalsis) of the intestine, and due to the presence of activated carbon, which has an antimicrobial and sorption effect, it reduces the processes of putrefaction and fermentation that may occur in the intestine.

Allohol is shown in the complex therapy of chronic cholecystitis, with cholangitis, and with symptoms of atonic constipation. It is usually taken in two tablets, after meals, so that it has the most choleretic effect. If the patient is prescribed fractional meals, then the remedy should be taken no more than 4 times. This technique must be observed for a month, and then it is halved in dosage. It is possible to repeat the course, but between them it is necessary to take breaks of at least 2 months.

Allohol is produced by the domestic company Pharmstandard, and a large package containing 50 coated tablets costs only 49 rubles. In some pharmacies, you can find it for 38 rubles, and the smallest pack of 10 tablets costs only 15 rubles.

Advantages and disadvantages

Allochol acts as a choleretic rather mildly, unlike synthetic drugs. Still, it contains natural bile. But, nevertheless, at a sufficiently high dosage, it can cause diarrhea and flatulence of the abdomen, and Allochol is contraindicated in acute ulcers, mechanical (obstructive) jaundice, and if there are stones in the gallbladder. This leads to a sharp increase in secretion, and if she has nowhere to go, then there may be an expansion of the bladder and even its rupture with the development of peritonitis. Allohol is contraindicated in acute and subacute hepatitis – inflammation of the liver, and with its progressive dystrophy. But this choleretic agent, taken according to indications, acts gently and helps to improve digestion and normalize stools in a wide variety of patient groups.

Hepatofalk Planta (milk thistle, turmeric, celandine)

Rating: 4.6

Another herbal preparation with a complex effect on the liver and biliary tract is presented on the pharmacy market by the German company Dr. Falk. These are capsules containing celandine root and herb, turmeric, and spotted milk thistle. If you open a greenish capsule, a light brown powder will pour out from there. This powder is able to have a complex choleretic and hepatoprotective effect.

The word “complex” means that milk thistle is not only a choleretic, but also a cholekinetic. That is, Plant’s Hepatofalk not only stimulates the formation of bile, but also its excretion. Additionally, it improves hepatocyte trophism and increases protein synthesis in the liver. This is a very important function for patients with chronic liver failure, and with active forms of hepatitis. If little protein is synthesized in the liver, this means that there will be little protein in the blood, hypoproteinemia will occur, the blood coagulation process will worsen, since the main protein is fibrinogen, which turns into fibrin and clogs the bleeding site with a clot, is produced in the liver. The liver supplies building proteins for the synthesis of antibodies, therefore, immunity indicators will also worsen on a low amount of protein.

Therefore, Hepatofalk Planta is a very important drug that is able to show an immune effect and improve blood clotting. In addition, the drug relaxes the smooth muscles of the internal organs, and acts as an antispasmodic, slightly reduces the severity of inflammatory reactions, has antibacterial activity and the ability to reduce oxidative stress.

Why does it produce all these effects? Silibinin from milk thistle protects the liver and binds toxins, chelidonin, which is contained in celandine, resolves spasms, anesthetizes and has a choleretic function, just like the active substance of turmeric.

Hepatofalk Planta is shown in the complex therapy of acute and chronic hepatitis. It is indicated for cirrhosis of the liver, including as a maintenance treatment, for toxic liver damage, alcoholic, medicinal. Hepatofalk Plant is prescribed for pain and spasms in case of gallbladder pathology, dyskinesia, cholangitis, chronic cholecystitis, and in case of damage to the biliary tract. It can be used in postcholecystectomy syndrome, as well as in the case of varicose veins of the gastrointestinal tract, that is, in a pathology known as portal hypertension. Most often, it develops against the background of severe cirrhosis, and is accompanied by ascites, that is, accumulation of fluid in the abdominal cavity. How is Hepatofalk Plant used? Before eating. In the first days, up to two weeks, you need to use 2 capsules 3 times a day, and then reduce the dose to 1 capsule. Thus, the course of treatment will be from 1 to 3 months. Repeated course in a month, also within one to three months.

Advantages and disadvantages

The disadvantage of this remedy is the same as that of absolutely all herbal remedies without exception. It is good only as a remedy in complex therapy, along with other drugs. This indication is especially important if it is necessary to reveal a strong choleretic effect, in which case it is necessary to turn to tubage procedures, or blind probing, and also take ursodeoxycholic acid preparations. But in the event that we are talking about moderate disorders of biliary kinetics, about such a pathology as biliary dyskinesia, then this drug will act gently and beneficially.

Of the side effects, there are rare allergic reactions, a slight loosening of the stool. Overdose is not described. In the presence of gallstone disease, it is necessary to consult a doctor. Indeed, in the event that there is obstruction of the biliary tract, or their blockage with a stone, then no choleretic agent can be used until the obstruction to the outflow of bile is eliminated.

Rosehip syrup (Holosas)

Rating: 4.5

Holosas is one of the most delicious and pleasant medicines in general, since it is a concentrated rosehip syrup with sugar. In some cases, if it is not hidden from small children, they can drink the whole bottle, and after that they will suffer from profuse diarrhea due to an overdose, but still, nothing bad will happen to them anymore. However, one should add a bitter fly in the ointment to a barrel of honey, more precisely, to a barrel of Holosas. for some reason, delicious, fragrant rosehip syrup has not been found in pharmacies for a long time. Instead, they sell some kind of chemical essence, similar in color, but not at all similar in taste, flavored with artificial sweeteners and flavors. There is absolutely no certainty that we have real rose hips in front of us. Therefore, in order to find the real Holosas, you will have to work hard.

Holosas is indicated for various viral hepatitis, for inflammation of the biliary tract and bladder, for poisoning with various drugs, drugs that are metabolized, secreted into bile, it is indicated for poisoning with alcoholic beverages. Holosas can be prescribed as a general tonic, and with vitamin C deficiency. One of its effects can be considered choleretic and cholekinetic, it perfectly prevents bile stasis.

It should be used 2 to 3 times a day, adults – 1 teaspoon per reception, and children – half a teaspoon, or even less. Holosas is produced by the domestic company ZAO Altaivitaminy, and the cost of one bottle of 140 ml is an average of 95 rubles.

Advantages and disadvantages

Holosas is a natural herbal monopreparation, and only individual intolerance, as well as severe diabetes mellitus, will be a contraindication, since Holosas contains sugar. There are no side effects of the drug, again, with the exception of individual intolerance. Few people will experience unpleasant side effects from the delicious rosehip syrup. This remedy is inexpensive, Holosas can be added to boiling water and drunk for general strengthening purposes. Taking one teaspoon of Holosas fully satisfies the daily need for ascorbic acid.

Hofitol (artichoke leaf extract)

Rating: 4.4

Another effective drug with a choleretic effect is artichoke leaf extract, or Hofitol. As you can see, there are many herbal remedies among choleretic agents. The second part of the choleretic ones is either bile acids, or even cattle bile, as in Allochol. Hofitol is available in two versions: either in the form of tablets, or an oral solution, which acts faster. In the case of a solution, this is a 20% solution, a 120 ml bottle. This tool is produced by the French company Rosa Fitofarm, and the cost of the solution is not so small: a minimum of 430 rubles, and a maximum of 520 rubles. for spring 2020. Tablets are somewhat cheaper. So, a package of 60 tablets of 200 mg will cost from 340 to 450 rubles.

What is this drug? Artichoke leaves contain phenolic acids, and a special substance is cynarine. In addition, the artichoke contains neurotropic vitamins, inulin, carotene and ascorbic acid. This allows the drug to have a hepatotropic and choleretic effect. It is a cholekinetic and choleretic, reduces inflammation in the biliary tract, and helps relieve spasm of smooth muscles. Hofitol is able to increase the secretion of bilirubin into bile, and increases the tone of the muscles of the gallbladder. It promotes the flow of bile into the duodenum. On the other hand, it has a relaxing effect on the muscles of the sphincters, and is able to change the viscosity of bile. It is indicated for dyskinesias, chronic hepatitis and cirrhosis, chronic cholecystitis, but necessarily non-calculous, that is, without stones and without the threat of blockage of the ducts. Adults need to use the product 2 tablets, or 5 ml of solution 3 times a day before meals. The course of treatment is not very long: up to 3 weeks.

Advantages and disadvantages

Hofitol also has an antibacterial effect. Hofitol is not indicated for children under 6 years of age, with acute pathology of the liver and kidneys, and calculous cholecystitis, as well as obstruction of the biliary tract. It can be prescribed to pregnant women, as well as to lactating women, but only with caution and under medical supervision. In case of an overdose, loosening of the stool is possible, and if it is used for a long time and in high doses, then, most often, diarrhea develops. Side effects may include allergic reactions. But, as practice shows, the use of herbal choleretic preparations rarely leads to the above conditions, and it is best to control the normal functioning of the gastrointestinal tract, timely curing chronic diseases, using an appropriate diet, and doing prevention.

Conclusion

In conclusion, attention should be paid to very important points regarding the appointment of choleretic drugs. The doctor and the patient should be aware that some choleretic drugs can adversely affect the mucous membrane of the stomach and intestines, and as a result, an increase in dyspepsia is possible. It is important that, without exception, all choleretic drugs are contraindicated in the presence of cholelithiasis, biliary strictures, and calculous cholecystitis. You should be aware that they can cause loosening of the stool, and it is undesirable to prescribe them for the corresponding diseases in which there is diarrhea. This is Crohn’s disease, or ulcerative colitis.

Separately, it must be said about the group of hydrocholeretics, the so-called therapeutic mineral waters, which are always prescribed for pathology of the liver and biliary tract outside the stage of exacerbation. Mineral salts that are in the waters are secreted by cells – hepatocytes into the bile capillaries, and improve the quantity and quality of bile, affecting the aqueous phase. The waters of Essentuki No. 4, Berezovskaya Ukrainian, Jermuk (Armenia), Slavyanovskaya, Naftusya water from Truskavets have choleretic effects.

Any mineral water with non-calculous chronic cholecystitis is taken warm, or even hot. The usual volume is from 1 to one and a half glasses, three times a day, always before meals, 30 minutes or even an hour and a half, depending on the state of the secretory function of the stomach. If we are talking about carbonated mineral waters, then the gas must be released from them.

And if you use mineral water correctly, then you can agree with the statement of S. P. Botkin that “mineral water rinses and cleans the bladder and bile ducts, and destroys the conditions for the further formation of stones.”

Attention! This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.