Gallbladder bile composition in patients with Crohn 's disease - PubMed (original) (raw)

Gallbladder bile composition in patients with Crohn 's disease

Annika Lapidus et al. World J Gastroenterol. 2006.

Abstract

Aim: To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn's disease.

Methods: Gallbladder bile was obtained from patients with Crohn's disease who were admitted for elective surgery (17 with ileal/ileocolonic disease and 7 with Crohn's colitis). Fourteen gallstone patients served as controls. Duodenal bile was obtained from ten healthy subjects before and after the treatment with ursodeoxycholic acid. Bile was analyzed for biliary lipids, bile acids, bilirubin, crystals, and crystal detection time (CDT). Cholesterol saturation index was calculated.

Results: The biliary concentration of bilirubin was about 50% higher in patients with Crohn's disease than in patients with cholesterol gallstones. Ten of the patients with Crohn's disease involving ileum and three of those with Crohn's colitis had cholesterol saturated bile. Four patients with ileal disease and one of those with colonic disease displayed cholesterol crystals in their bile. About 1/3 of the patients with Crohn's disease had a short CDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin in duodenal bile. Several patients with Crohn's disease, with or without ileal resection/disease had gallbladder bile supersaturated with cholesterol and short CDT and contained cholesterol crystals. The biliary concentration of bilirubin was also increased in patients with Crohn's colitis probably not due to bile acid malabsorption.

Conclusion: Several factors may be of importance for the high risk of developing gallstones of both cholesterol and pigment types in patients with Crohn's disease.

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References

1. 1. Cohen S, Kpplan M, Gottlieb L, Patterson J. Liver disease and gallstones in regional enteritis. Gastroenterology. 1971;60:237–245. - PubMed
2. 1. Harrower AD, Davidson NM, Yap PL, Nairn IM, Fyffe JA, Horn DB, Strong JA. Hypothalmic-pituitary adrenal responsiveness to dexamethasone-insulin tolerance test in acromegalic patients before and during treatment with bromocriptine. Acta Endocrinol (Copenh) 1978;88:18–22. - PubMed
3. 1. Hill GL, Mair WS, Goligher JC. Gallstones after ileostomy and ileal resection. Gut. 1975;16:932–936. - PMC - PubMed
4. 1. Whorwell PJ, Hawkins R, Dewbury K, Wright R. Ultrasound survey of gallstones and other hepatobiliary disorders in patients with Crohn's disease. Dig Dis Sci. 1984;29:930–933. - PubMed
5. 1. Lorusso D, Leo S, Mossa A, Misciagna G, Guerra V. Cholelithiasis in inflammatory bowel disease. A case-control study. Dis Colon Rectum. 1990;33:791–794. - PubMed

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