Skip to main content
Gut logoLink to Gut
. 1979 Apr;20(4):312–317. doi: 10.1136/gut.20.4.312

Rowachol--a possible treatment for cholesterol gallstones.

J Doran, M R Keighley, G D Bell
PMCID: PMC1412390  PMID: 447112

Abstract

It has been claimed that Rowachol, a proprietary choleretic, is occasionally successful in the treatment of gallstones. In gallstone patients we have examined its effect on the lipid composition of (1) samples of fasting gall bladder bile obtained at the time of cholecystectomy, and (2) T-tube bile on the tenth post-operative day. In a dose of two capsules, three times a day for only 48 hours, Rowachol significantly lowered the cholesterol solubility of both gall bladder (P less than 0.001) and T-tube bile (P less than 0.05). Rowachol in a dose of one capsule three times a day for 48 hours did not alter bile composition, while four capsules four times a day for a similar period caused a significant (P less than 0.05) deterioration in biliary lipid composition. The possible mechanisms of action of Rowachol and their therapeutic implications are discussed.

Full text

PDF
312

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Admirand W. H., Small D. M. The physicochemical basis of cholesterol gallstone formation in man. J Clin Invest. 1968 May;47(5):1043–1052. doi: 10.1172/JCI105794. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BARTLETT G. R. Phosphorus assay in column chromatography. J Biol Chem. 1959 Mar;234(3):466–468. [PubMed] [Google Scholar]
  3. BLUMENBERG F. W. Therapie von Cholepathien mit einer Terpenkombination. Medizinische. 1957 May 11;(19):726–728. [PubMed] [Google Scholar]
  4. Begemann F., Bandomer G., Herget H. J. The influence of beta-sitosterol on biliary cholesterol saturation and bile acid kinetics in man. Scand J Gastroenterol. 1978;13(1):57–63. doi: 10.3109/00365527809179806. [DOI] [PubMed] [Google Scholar]
  5. Bell C. D., Doran J., Middleton A., Middleton B., Richmond C. R., White D. A. Rowachol, a proprietary terpene preparation, dissolves cholesterol gallstones [proceedings]. Br J Clin Pharmacol. 1978 Nov;6(5):454P–454P. doi: 10.1111/j.1365-2125.1978.tb04625.x. [DOI] [PubMed] [Google Scholar]
  6. Bell G. D., Doran J., Fayadh M., Murphy G., Dowling R. H. Effect of ioglycamide (Biligram) on bile flow and biliary lipid secretion in man. Gut. 1978 Apr;19(4):300–307. doi: 10.1136/gut.19.4.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Bell G. D., Whitney B., Dowling R. H. Gallstone dissolution in man using chenodeoxycholic acid. Lancet. 1972 Dec 9;2(7789):1213–1216. doi: 10.1016/s0140-6736(72)92266-0. [DOI] [PubMed] [Google Scholar]
  8. CARR J. J., DREKTER I. J. Simplified rapid technic for the extraction and determination of serum cholesterol without saponification. Clin Chem. 1956 Oct;2(5):353–368. [PubMed] [Google Scholar]
  9. Coyne M. J., Bonorris G. G., Chung A., Goldstein L. I., Lahana D., Schoenfield L. J. Treatment of gallstones with chenodeoxycholic acid and phenobarbital. N Engl J Med. 1975 Mar 20;292(12):604–607. doi: 10.1056/NEJM197503202921202. [DOI] [PubMed] [Google Scholar]
  10. Coyne M. J., Bonorris G. G., Goldstein L. I., Schoenfield L. J. Effect of chenodeoxycholic acid and phenobarbital on the rate-limiting enzymes of hepatic cholesterol and bile acid synthesis in patients with gallstones. J Lab Clin Med. 1976 Feb;87(2):281–291. [PubMed] [Google Scholar]
  11. Danzinger R. G., Hofmann A. F., Schoenfield L. J., Thistle J. L. Dissolution of cholesterol gallstones by chenodeoxycholic acid. N Engl J Med. 1972 Jan 6;286(1):1–8. doi: 10.1056/NEJM197201062860101. [DOI] [PubMed] [Google Scholar]
  12. Dowling R. H. Chenodeoxycholic acid therapy of gallstones. Clin Gastroenterol. 1977 Jan;6(1):141–163. [PubMed] [Google Scholar]
  13. Gerolami A., Sarles H. Letter: Beta-sitosterol and chenodeoxycholic acid in the treatment of cholesterol gallstones. Lancet. 1975 Oct 11;2(7937):721–721. doi: 10.1016/s0140-6736(75)90835-1. [DOI] [PubMed] [Google Scholar]
  14. Hegardt F. G., Dam H. The solubility of cholesterol in aqueous solutions of bile salts and lecithin. Z Ernahrungswiss. 1971 Apr;10(3):223–233. doi: 10.1007/BF02020933. [DOI] [PubMed] [Google Scholar]
  15. Hordinsky B. Z. Terpenes in the treatment of gallstones. Minn Med. 1971 Aug;54(8):649–652. [PubMed] [Google Scholar]
  16. Igimi H., Hisatsugu T., Nishimura M. The use of d-limonene preparation as a dissolving agent of gallstones. Am J Dig Dis. 1976 Nov;21(11):926–939. doi: 10.1007/BF01071903. [DOI] [PubMed] [Google Scholar]
  17. Iser J. H., Dowling H., Mok H. Y., Bell G. D. Chenodeoxycholic acid treatment of gallstones. A follow-up report and analysis of factors influencing response to therapy. N Engl J Med. 1975 Aug 21;293(8):378–383. doi: 10.1056/NEJM197508212930804. [DOI] [PubMed] [Google Scholar]
  18. Kodama R., Inoue H., Noda K., Ide H., Yamamoto H. Effect of d-limonene and related compounds on bile flow and biliary lipid composition in rats and dogs. Life Sci. 1976 Nov 15;19(10):1559–1567. doi: 10.1016/0024-3205(76)90102-8. [DOI] [PubMed] [Google Scholar]
  19. Maton P. N., Murphy G. M., Dowling R. H. Ursodeoxycholic acid treatment of gallstones. Dose-response study and possible mechanism of action. Lancet. 1977 Dec 24;2(8052-8053):1297–1301. doi: 10.1016/s0140-6736(77)90358-0. [DOI] [PubMed] [Google Scholar]
  20. Mörsdorf K., Wolf G. Untersuchungen zur Wirkungspotenz einiger Choleretika. Dtsch Med J. 1966 May 31;17(10):303–306. [PubMed] [Google Scholar]
  21. Nicolau G., Shefer S., Salen G., Mosbach E. H. Determination of hepatic 3-hydroxy-3-methylglutaryl CoA reductase activity in man. J Lipid Res. 1974 Jan;15(1):94–98. [PubMed] [Google Scholar]
  22. Noda H., Kuriyama S., Tokuda A. [Clinico-pathological studies on cholelithiasis. II. Medical treatment of choleithiasis experience of therapy with terebene oil preparation]. Naika Hokan. 1965 Sep;12(9):505–511. [PubMed] [Google Scholar]
  23. Salen G., Nicolau G., Shefer S., Mosbach E. H. Hepatic cholesterol metabolism in patients with gallstones. Gastroenterology. 1975 Sep;69(3):676–684. [PubMed] [Google Scholar]
  24. TALALAY P. Enzymic analysis of steroid hormones. Methods Biochem Anal. 1960;8:119–143. doi: 10.1002/9780470110249.ch3. [DOI] [PubMed] [Google Scholar]
  25. Thistle J. L., Hofmann A. F. Efficacy and specificity of chenodeoxycholic acid therapy for dissolving gallstones. N Engl J Med. 1973 Sep 27;289(13):655–659. doi: 10.1056/NEJM197309272891303. [DOI] [PubMed] [Google Scholar]
  26. Thistle J. L., Hofmann A. F., Ott B. J., Stephens D. H. Chenotherapy for gallstone dissolution. I. Efficacy and safety. JAMA. 1978 Mar 13;239(11):1041–1046. [PubMed] [Google Scholar]
  27. Thomas P. J., Hofmann A. F. Letter: A simple calculation of the lithogenic index of bile: expressing biliary lipid composition on rectangular coordinates. Gastroenterology. 1973 Oct;65(4):698–700. [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES