Distension of the gall bladder inhibits sphincter of Oddi motility in humans.

Thune, Anders; Saccone, G. T. P.; Scicchitano, J.; Toouli, James

doi:10.1136/gut.32.6.690

Cited by 55 publications

(25 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Sphincter of Oddi contraction induced by intraduodenal bile salts may lead to gall bladder distension through a local reflex pathway between the gall bladder and sphincter. 45 We found that gall bladder dilatation occurred on intraduodenal infusion of mixed micelles, regardless of the presence (study A) or absence (study B) of cholesterol within these micelles. In contrast, the effects of infused TC micelles depended to a large extent on the amounts and acyl chain composition of the phosphatidylcholines that were incorporated in these micelles.…”

Section: Discussionmentioning

confidence: 65%

Intraduodenal conjugated bile salts exert negative feedback control on gall bladder emptying in the fasting state without affecting cholecystokinin release or antroduodenal motility

Ooteghem¹

2002

Gut

View full text Add to dashboard Cite

Background: Intraduodenal bile salts exert negative feedback control on postprandial gall bladder emptying. Aims: We wished to examine whether a similar control mechanism occurs in the fasting state. Methods: Intraduodenal bile salt depletion was achieved by 12 g of cholestyramine. Thereafter, in study A (seven subjects), the effects on gall bladder volume (by ultrasound) and antroduodenal motility of intraduodenal infusions of taurocholate egg yolk-phosphatidylcholine micelles were assessed. In study B (nine subjects), the effects on gall bladder volume of infusing mixed micelles composed of taurocholate (100 mM) and low (26 mM) or high (68 mM) amounts of egg yolk-phosphatidylcholine, or low amounts of dipalmitoylphosphatidylcholine were determined. Results: Cholestyramine induced strong and prolonged gall bladder contraction without cholecystokinin release. In study A, micellar infusions increased gall bladder volume without affecting migrating motor complex cycle length. In study B, intraduodenal infusion induced strong increases in gall bladder volume in the case of taurocholate micelles containing low amounts of egg yolk-phosphatidylcholine, moderate increases in micelles containing low amounts of dipalmitoylphosphatidylcholine but no change in micelles containing high amounts of egg yolk-phosphatidylcholine, in all cases without altered plasma cholecystokinin levels. Phosphatidylcholine hydrolysis was significantly higher after infusion of egg yolk-phosphatidylcholine compared with infusion of dipalmitoylphosphatidylcholine containing micelles. Intermixed micellar-vesicular bile salt concentrations (responsible for detergent effects) were higher in egg yolk-phosphatidylcholine than in dipalmitoylphosphatidylcholine containing model biles and if lyso-phosphatidylcholine was included. Conclusions: Intraduodenal bile salts exert negative feedback on fasting gall bladder volume. The modulating effects of various phospholipids may relate to their effects on intermixed micellar-vesicular bile salt concentrations.

show abstract

Section: Discussionmentioning

confidence: 65%

Intraduodenal conjugated bile salts exert negative feedback control on gall bladder emptying in the fasting state without affecting cholecystokinin release or antroduodenal motility

Ooteghem¹

2002

Gut

View full text Add to dashboard Cite

show abstract

“…For example, it is known that maximal basal pressure is the SO motor variable which best correlates with hepatoduodenal bile transit time, at least in postcholecystectomy subjects25 35; in addition, several investigations in animals and humans indicate that SO sphincterotomy is followed by a reduction in gall bladder volume and improved gall bladder emptying function, even in the presence of gall stones 1314 36-41 It can therefore be hypothesised that the increased SO pressure in gall stone patients would inhibit bile flow into the duodenum and facilitate bile flow into, and storage in, the gall bladder thus offering a possible explanation for the common finding of an increase in fasting gall bladder volume in gall stone patients 7-9…”

Section: Discussionmentioning

confidence: 99%

Increased sphincter of Oddi basal pressure in patients affected by gall stone disease: a role for biliary stasis and colicky pain?

Cicala

Habib

Fiocca

et al. 2001

Gut

View full text Add to dashboard Cite

Background and aims-Even if the motor activity of the gall bladder and sphincter of Oddi (SO) are integrated, it is not known if the presence of stones in the gall bladder aVects SO function. The aim of the study was to compare SO motor activity in patients with and without gall stones. Patients and methods-In a series of 155 patients consecutively submitted to endoscopic retrograde cholangiopancreatography and SO manometry for suspected biliary or pancreatic disease, 23 gall stone patients had recurrent episodes of biliary or pancreatic pain (colicky group); 52 patients had non-biliary/pancreatic-type abdominal pain/discomfort, and of these, 15 had gall stones (non-colicky group), 25 were free of stones (controls), and 12 had undergone cholecystectomy. Results-SO basal pressure in gall stone patients in the colicky or non-colicky group was significantly higher than in controls (p<0.001). SO basal pressure recorded in postcholecystectomy patients did not diVer from controls. SO phasic activity did not diVer between the patient groups. SO dysfunction was detected in more than 40% of gall stone patients irrespective of associated biliary/pancreatic pain but in none of the control subjects (p<0.001). Conclusions-Gall stones are frequently associated with increased SO tone which may obstruct bile flow thus acting to facilitate gall bladder stasis, and may play a role as a cofactor in biliary/pancreatic pain. (Gut 2001;48:414-417)

show abstract

“…Electrical stimulation of the gallbladder produced a fall in Sphincter of Oddi pressure in dogs 3 . Subsequently studies in humans demonstrated that distention of the gallbladder decreased resistance to flow by reducing the amplitude and decreasing the basal pressure, thus promoting the flow of bile 4 . This response of the Sphincter of Oddi to gallbladder distention, cholecystic‐sphincter of Oddi reflex, is mediated via neural connections between the gallbladder and the sphincter.…”

Section: Control Of Sphincter Of Oddi Motilitymentioning

confidence: 99%

Sphincter of Oddi: Function, dysfunction, and its management

Toouli

2009

J of Gastro and Hepatol

View full text Add to dashboard Cite

The most common functional disorder of the biliary tract and pancreas relates to the activity of the Sphincter of Oddi. The Sphincter of Oddi is a small smooth muscle sphincter strategically placed at the junction of the bile duct, pancreatic duct, and duodenum. The sphincter controls flow of bile and pancreatic juices into the duodenum and prevents reflux of duodenal content into the ducts. Disorder in its motility is called Sphincter of Oddi dysfunction. Clinically this presents either with recurrent abdominal biliary type pain or episodes of recurrent pancreatitis. Manometry may identify the motility abnormalities, the most clinically significant being an abnormally elevated basal pressure. The most effective treatment once an abnormal basal pressure is identified is division of the sphincter. This is associated with good long-term results.

show abstract

Distension of the gall bladder inhibits sphincter of Oddi motility in humans.

Cited by 55 publications

References 15 publications

Intraduodenal conjugated bile salts exert negative feedback control on gall bladder emptying in the fasting state without affecting cholecystokinin release or antroduodenal motility

Intraduodenal conjugated bile salts exert negative feedback control on gall bladder emptying in the fasting state without affecting cholecystokinin release or antroduodenal motility

Increased sphincter of Oddi basal pressure in patients affected by gall stone disease: a role for biliary stasis and colicky pain?

Sphincter of Oddi: Function, dysfunction, and its management

Contact Info

Product

Resources

About