Treatment of primary biliary cirrhosis (PBC) and primary sclerotizing cholangitis (PSCH) by ursodesoxycholic acid (UCDA) was supplemented by a Carlsbad water drinking cure (CDC). The objective of the investigation was to assess whether CDC is a suitable supplement of UCDA admnistrati- on in diseases with intrahepatic cholestasis. Material and methods: The authors investigated the clinical and biochemical course of CDC in a group of 24 patients incl. 18 who suffered from PBC and 2 from PSCH and were treated by UDCA, and four controls (3 with PBC and one with PSCH) who were not treated with UDCA. Three patients treated with UDCA and one not treated with UDCA were repeatedly treated by CDC. Results: During CDC clinical deterioration did not occur. In subjects treated with UDCA who before CDC reported increased fatigue, after CDC in the majority fatigue receded and itching of the skin was milder or disappeared completely. This was not observed in any of the controls. During concurrent UDCA treatment from the beginning to the end of CDC a significant decline of the mean concentration of total bilirubin was recorded (p < 0.05) but not of the mean value of conjugated serum bilirubin (p < 0.08) nor alkaline phosphata- se, gammaglutamyl transpeptidase and both aminotranferases. During CDC a rise of enzymes which could indicate general deterioration of cholestasis or liver damage did not occur. In some subjects also initial high total serum bilirubin values declined. Repeated CDC in three of four subjects led to improvement and stabilization of the biochemical findings. CDC can therefore be considered a possible and suitable supplement of long-term UCDA treatment in PBC and probably also PSCH. The results in subjects not treated with UDCA are not at variance with this statement.

        Key words: primary biliary cirrhosis – primary sclerotizing cholangitis – ursodesoxycholic acid – Carlsbad