ULTRA Pain Study - Ursodeoxycholic acid in Low Phospholipid Associated Cholelithiasis (LPAC) Treating Recurrent Abdominal Pain Study

Some people continue to experience severe abdominal pain even after having their gallbladder removed — a condition that can be caused by Low Phospholipid-Associated Cholelithiasis (LPAC), a genetic condition that causes stones to form in the bile ducts inside the liver. This trial tests whether ursodeoxycholic acid, a bile acid medication, can prevent this pain, reduce hospital admissions, and improve quality of life. You may be eligible if you are 18 or older, have had your gallbladder removed, and experience more than two episodes of biliary pain per year, along with at least two other features suggesting LPAC (such as being under 40 at the time of your first biliary symptoms, specific ultrasound findings, or a family history of gallbladder surgery before age 40). People with stones in the common bile duct, inflammatory bowel disease, significant psychiatric disorders, or active pregnancy are not eligible. This is a crossover trial, meaning all participants take the real medication for one year and the placebo for another year (in random order), with a 2-week washout in between. The main outcome is how many pain episodes occur on each treatment. If effective, this medication could offer a much-needed solution for a painful and often misunderstood condition.