Gallbladder disease risk — cholelithiasis data from clinical trials

Dr.GastroMayo said:

Relative and absolute effects need reading together.

Thank you — that is the clearest version of this I have read, and I have read a lot of them.

Adding the clinical framing, because it changes how the question reads.

Gallbladder ultrasound monitoring on gallbladder risk: given the known gallstone risk with rapid weight loss, my doctor orders gallbladder ultrasound every 6 months:

Baseline: normal, no stones or sludge
Month 6: small amount of biliary sludge, no stones
Month 12: sludge resolved, gallbladder normal

Ursodeoxycholic acid (Ursodiol) 300mg BID was prescribed prophylactically from the start. This reduces gallstone formation during rapid weight loss by ~60% per the available data. Ask your doctor about prophylactic ursodiol if you're losing weight rapidly.

Dr.PainCLE said:

The gap between trial results and real-world results is consistent and it is not fraud.

I read this differently. The confidence in this thread is running ahead of the evidence, and I would rather the uncertainty were stated than smoothed over because it is unsatisfying.

Ask again with the specifics and you will get a better answer than this one.

One concrete data point for the thread. If you are comparing against somebody else’s result, check that you are comparing the same measurement taken the same way. Most of the apparent contradictions in these threads dissolve at that step.

Worth separating that from the trial evidence, which this thread keeps folding into the same question. They behave differently and the advice does not transfer.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful.