Evidence supporting the use of: Bile acid
For the health condition: Cirrhosis of the Liver

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Bile acids, particularly ursodeoxycholic acid (UDCA), have been investigated and used in the management of certain types of liver disease, including some forms of cirrhosis. The scientific rationale for their use stems from their ability to reduce the toxicity of more hydrophobic bile acids, improve bile flow, and exert anti-inflammatory, immunomodulatory, and anti-fibrotic effects in the liver. UDCA is an established therapy for primary biliary cholangitis (PBC), a chronic cholestatic liver disease that can progress to cirrhosis. In this context, UDCA has been shown in randomized controlled trials to improve liver biochemistry, slow disease progression, and increase survival without transplantation. However, for cirrhosis in general—particularly cirrhosis arising from causes like hepatitis B, hepatitis C, or alcoholic liver disease—the evidence for bile acids as a treatment is limited. Most guidelines do not recommend bile acid therapy for cirrhosis of other etiologies due to a lack of significant clinical benefit demonstrated in trials. While bile acids may improve cholestasis and symptoms in certain subgroups, they do not reverse established cirrhosis or significantly impact outcomes outside of specific cholestatic diseases. Thus, while there is scientific evidence supporting the use of UDCA in cholestatic liver disease-related cirrhosis, its use for cirrhosis in general is not broadly validated.

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