What medication can dissolve gallstones in symptomatic patients?

Ursodeoxycholic acid is a bile acid that can effectively dissolve certain types of gallstones, particularly those that are cholesterol-based. It works by reducing the cholesterol saturation of bile, which can help to dissolve gallstones gradually over time in symptomatic patients. This approach is particularly useful for patients who are not surgical candidates or those who prefer to avoid surgery.

In addition to its ability to dissolve stones, ursodeoxycholic acid can also help to improve liver function in patients with conditions such as primary biliary cholangitis. Its role in gallstone management underscores its importance in specific clinical scenarios where surgery may not be feasible.

Other medications listed, such as amoxicillin, which is an antibiotic, serve different purposes and do not impact gallstone dissolution. Metformin, primarily used for managing type 2 diabetes, has no role in gallstone therapy. Esomeprazole is a proton pump inhibitor used for acid-related disorders and does not influence gallstone formation or dissolution. Thus, in the context of dissolving gallstones, ursodeoxycholic acid is the most relevant and effective choice.