Decholin (Dehydrocholic Acid): Indications, Mechanism, and Clinical Use

Dehydrocholic acid (Decholin) is a synthetic bile acid derivative classified as a choleretic and cholagogue.

Mechanism of Action

• Stimulates hepatic bile secretion (choleretic)
• Promotes gallbladder contraction and bile flow into duodenum (cholagogue)
• Reduces bile viscosity, prevents stasis

Clinical Indications

• Post-cholecystectomy syndrome (bile flow dysregulation)
• Chronic cholecystitis (non-surgical candidates)
• Biliary dyskinesia
• Adjunct in fat malabsorption (cystic fibrosis, pancreatic insufficiency)
• Constipation of biliary origin
• Preoperative biliary preparation (historical)

Dosing and Administration

• Oral tablets (250–500 mg) 3–4 times daily before meals
• Duration: acute (days-weeks) or chronic maintenance

Adverse Effects

• GI: diarrhea, cramping, nausea (dose-related)
• Electrolyte imbalance with chronic diarrhea
• Rare: hypersensitivity

Contraindications/Precautions

• Complete biliary obstruction (may worsen pressure)
• Acute cholecystitis with obstruction
• Pregnancy/lactation (insufficient data)
• Pediatric (not established)

Current Status

Less commonly used today; largely replaced by ursodeoxycholic acid (UDCA) for cholestatic conditions and more targeted therapies. Still available in some formularies.