Cholagogues

substances of synthetic or plant origin that increase the discharge of bile into the duodenum, stimulate its formation in the liver cells, or increase its passage through the biliary tracts.

Some cholagogues perform more than one of these functions. They act directly on the process of bile production and through the neurohumoral system of metabolic regulation (in particular, carbohydrate-phosphorus metabolism). The formation of bile is intensified under the influence of gastric juice, orally administered acidic fluids, mineral waters, egg yolks, mechanical irritation of the gastric mucosa, and the entry of bile or bile acids into the intestinal tract. The most commonly used pharmacological stimulants of bile formation are preparations of bile acids (dihydrocholic acid, or Chologon, Decholin) and natural bile (allochol, cholenzym). They cause an increase in the secretion of bile salts and an increase in the total quantity of bile secreted. Some plant remedies have a cholagogic effect; including rose fruit extracts (cholosas), or infusions of everlastings. The new synthetic cholagogic agents, such as oxaphenamide and cyclovalone, have cholagogic, antiseptic, and anti-inflammatory properties. To relax the muscular clamp that overlaps the ostium of the common bile duct within the duodenal wall, magnesium sulfate, spasmolytic agents, or mineral waters such as Borzhomi, Essentuki No. 4 and No. 17, Smirnov, Slavianov, Sairme, and Arzni may be prescribed.

Cholagogues are used principally in the treatment of chronic inflammatory diseases of the liver and gallbladder (cholescystitides, cholangitides, cholecystohepatitides) and in cholelithiasis. Antiseptic drugs are often prescribed simultaneously with cholagogic agents in these diseases. An elevation of pressure in the gallbladder by means of cholagogic agents is sometimes used to expel small calculi that are blocking the duct.