A0476 - Potential Therapeutic Benefit of Ursodeoxycholic Acid (UDCA) in the Management of Non-Hepato-Biliary Upper Gastrointestinal Disorders: A Systemic Review

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Yasir M. Khayyat, MBChB

Umm AlQura University
Makkah, Makkah, Saudi Arabia

Yasir M. Khayyat, MBChB¹, Mohammed Y. Khayyat, MBBCh²
¹Umm AlQura University, Makkah, Makkah, Saudi Arabia; ²King Abdul Aziz University, Jeddah, Makkah, Saudi Arabia

Introduction: Ursodeoxycholic acid (UDCA) is a secondary bile acid with different therapeutic effects on the hepatobiliary tree. Little is known of the local effects of UDCA as a therapy of upper gastrointestinal tract disorders. These diseases that relate to acid peptic, inflammatory and premalignant etiologies in which gaps of the current treatment do exist. Our aim to search for UDCA therapeutic effect and review its role on the management effect of diseases of the esophagus, stomach and Duodenum if exist and describe its therapeutic potential.

Methods: Search of Medline, PubMed, EBSO, Google Scholar, Web of Science and International guidelines using MESH terms describing therapy of UDCA for diseases of the upper gastrointestinal disorders in adult humans with no language or publication date restrictions.

Results: A 256 articles and 22 guidelines initially identified, in whom 221 excluded, Final revision of 13 article and 22 guidelines showed that UDCA is found to have a cytoprotective role in Barret’s esophagus among esophageal disorders, it improves abdominal pain in functional dyspepsia and does not alter colonization of Helicobacter pylori and its inflammation. In the duodenum a conflicting result on the role of UDCA as chemoprevention for familial adenomatous polyposis, with regression of polyps and its growth characteristics with low doses used (10-25 mg/kg/day) alone. In contrary, no positive effect observed when combined with Celecoxib and with doses of 1000-2000 mg or 20-30 mg/kg/d. Side effects profile is predominantly related to Gastrointestinal side effects and no side effect attributed to morbidity or ICU admission.

Discussion: UDCA has limited therapeutic role in few uncontrolled small studies for functional dyspepsia. Its chemopreventive role is promising for Familial adenomatous polyposis and Barret’s esophagus, await further studies to support these roles.

Figure: Search Protocol of the role of UDCA in the Management of Non hepatobiliary Upper Gastrointestinal Disorders.

Type	Events (n) Frequency
Gastrointestinal	Abdominal Pain (1) 2.5 % Anal and Perianal Pain (4) 10% Heartburn (1) 2.5 % Constipation (3) 7.5 % Diarrhea (2) 5 % Bloating (1) 2.5 % Flatulence (1) 2.5 % Nausea (1) 2.5 % Vomiting (1) 2.5 % Dyspepsia (3) 7.5 % Terminal ileum Ulceration (1) 2.5 % Elevated AST and GGT (1) 2.5 %
Neurologic	Dizziness (1) 2.5 % Mood alteration (1) 2.5 % Neuropathy, Carpal tunnel syndrome (1) 2.5 %
Renal	Lower urinary tract symptom, Prostatism (1) 2.5 %
Skin	Hair loss (1) 2.5 % Skin Rash (2) 5%
Hematology	Anemia (1) 2.5 % Leukopenia (1) 2.5 %
Auditory	Otitis (1) 2.5 %
Infection	Dental Infection (1) 2.5 % Skin Infection (1) 2.5 % Gastroenteritis (1) 2.5 %
Lymphatics	Lower Limbs edema (2) 5%
Metabolic	Hypokalemia (1) 2.5 %
Constitutional	Fatigue (2) 5 % Insomnia (1) 2.5 %
Malignancy	Basal cell carcinoma, nose (1) 2.5 %
Total Events (n) %	40

Table: Reported Side effects of UDCA use.

Disclosures:

Yasir Khayyat indicated no relevant financial relationships.

Mohammed Khayyat indicated no relevant financial relationships.

Yasir M. Khayyat, MBChB¹, Mohammed Y. Khayyat, MBBCh². A0476 - Potential Therapeutic Benefit of Ursodeoxycholic Acid (UDCA) in the Management of Non-Hepato-Biliary Upper Gastrointestinal Disorders: A Systemic Review, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.