Gallbladder Hypokinesia in Crohn’s Disease

Damião, Adérson; Sipahi, Aytan Miranda; Vezozzo, Denise P.; Gonçalves, Patrícia Lofêgo; Fukui, Pedro; Laudanna, Antônio Atílio

doi:10.1159/000201483

Cited by 34 publications

(12 citation statements)

References 25 publications

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“…The authors speculate that in these patients, decreased bile acid absorption would result in higher bilirubin solubilisation in the colon and increased bilirubin reabsorption. iii) Additional mechanisms for gallstones in IBD patients include prolonged fasting state, parenteral nutrition and decreased gall bladder motility [27, 28]. One study concluded that intestinal surgery itself, not the altered anatomy after surgery would increase the risk of gallstones [4].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for gallstones and kidney stones in a cohort of patients with inflammatory bowel diseases

et al. 2017

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BackgroundGallstones and kidney stones are known complications of inflammatory bowel diseases (IBD). Risk factors have been insufficiently studied and explanatory studies date back up to 30 years. It remains unclear, whether improved treatment options also influenced risk factors for these complications.ObjectivesIdentifying risk factors for gallstones and kidney stones in IBD patients.MethodsUsing data from the Swiss Inflammatory Bowel Disease Cohort Study we assessed associations of diseases characteristics with gallstones and kidney stones in univariate and multivariate logistic regression analyses.ResultsOut of 2323 IBD patients, 104 (7.8%) Crohn’s disease (CD) and 38 (3.8%) ulcerative colitis (UC) patients were diagnosed with gallstones. Significant risk factors for gallstones were diagnosis of CD, age at diagnosis, disease activity and duration, NSAID intake, extra-intestinal manifestations and intestinal surgery. Kidney stones were described in 61 (4.6%) CD and 30 (3.0%) UC patients. Male gender, disease activity, intestinal surgery, NSAID usage and reduced physical activity were significant risk factors. Hospitalization was associated with gallstones and kidney stones. The presence of gallstones increased the risk for kidney stones (OR 4.87, p<0.001).ConclusionThe diagnosis of CD, intestinal surgery, prolonged NSAID use, disease activity and duration and bowel stenosis were significantly associated with cholecystonephrolithiasis in IBD.

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Section: Discussionmentioning

confidence: 99%

Risk factors for gallstones and kidney stones in a cohort of patients with inflammatory bowel diseases

et al. 2017

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“…This mechanism has been accepted for a long time as the most important in CD-related gallstone formation 27 ; however, recent animal and human data have shown that cholesterol supersaturation is a transient phenomenon after ileal resection and an increased channeling of cholesterol into de novo synthesis to compensate for increased intestinal loss of bile acids rapidly occur 28 ; (2) a reduced gallbladder motility in patients with CD, which may facilitate GD formation in the presence of cholesterol supersaturation. In this regard, some evidence has been seen of an impaired fatty-meal-induced gallbladder motility in patients with ileal and ileocolonic disease, 29,30 and Annese and Vantrappen also demonstrated decreased gallbladder contractility in patients with inactive CD 31 ; (3) a marked reduction in gallbladder emptying associated with fasting and total parenteral nutrition; a prolonged fasting state or the use of total parenteral nutrition both can induce biliary sludge due to reduced gallbladder emptying. 32 Because these factors are common in patients undergoing surgery for CD, the association between stones and intestinal resection may be attributed also to these perioperative defects in gallbladder motility.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for gallstones in patients with inflammatory bowel disease: A large case-control study

et al. 2007

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The risk for gallstones (GD) in inflammatory bowel diseases and the factors responsible for this complication have not been well established. We studied the incidence of GD in a cohort of Crohn's disease (CD) and ulcerative colitis (UC) patients and investigated the related risk factors. A case-controlled study was carried out. The study population included 634 inflammatory bowel disease (IBD) patients (429 CD, 205 UC) and 634 age-matched, sex-matched, and body mass index (BMI)-matched controls free of GD at enrollment, who were followed for a mean of 7.2 years (range, 5-11 years).The incidence of GD was calculated by dividing the number of events per person-years of follow-up. Multivariate analysis was used to discriminate among the impact of different variables on the risk of developing GD. The incidence rates of GD were 14.35/1,000 persons/year in CD as compared with 7.

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“…After ileal resection, anaerobic bacteria colonization can also deconjugate bile acids decreasing the absorptive capacity of mucosa. Furthermore, CD patients have reduced gallbladder motility owing to prolonged fasting period, which may also lead to the development of cholelithiasis . Systematic cholecystectomy after an ileal resection is, however, not recommended …”

Section: Other Hepatic Manifestations Than Psc Affecting Ibd Patientsmentioning

confidence: 99%

Hepatic manifestations of inflammatory bowel diseases

Restellini

Chazouillères

Frossard

2016

Liver International

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Inflammatory bowel diseases are associated with various hepatobiliary disorders, reported both in Crohn's disease and ulcerative colitis. They may occur at any moment in the natural course of the disease. The prevalence of liver dysfunction rises from 3% to 50% accordingly to definitions used in different studies. Fatty liver is considered as the most common hepatobiliary complication in inflammatory bowel diseases while primary sclerosing cholangitis is the most specific one. Less frequently, inflammatory bowel diseases-associated hepatobiliary disorders include: autoimmune hepatitis/ primary sclerosing cholangitis overlap syndrome, IgG4-associated cholangiopathy, primary biliary cholangitis, hepatic amyloidosis, granulomatous hepatitis, cholelithiasis, portal vein thrombosis and liver abscess. The spectrum of these manifestations varies according to the type of inflammatory bowel diseases. Treatments of inflammatory bowel diseases may cause liver toxicity, although incidence of serious complications remains low. However, early diagnosis of drug-induced liver injury is of major importance as it affects future clinical management. When facing abnormal liver tests, clinicians should undertake a full diagnostic work-up in order to determine whether the hepatic abnormalities are related to the inflammatory bowel diseases or not.Management of hepatic manifestations in inflammatory bowel diseases usually involves both hepatologists and gastroenterologists because of the complexity of some situations. K E Y W O R D Sdrug-induced liver injury, hepatotoxicity, inflammatory bowel disease, liver disease, primary sclerosing cholangitis

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Gallbladder Hypokinesia in Crohn’s Disease

Cited by 34 publications

References 25 publications

Risk factors for gallstones and kidney stones in a cohort of patients with inflammatory bowel diseases

Risk factors for gallstones and kidney stones in a cohort of patients with inflammatory bowel diseases

Incidence and risk factors for gallstones in patients with inflammatory bowel disease: A large case-control study

Hepatic manifestations of inflammatory bowel diseases

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