Gastrointestinal defects in gallstone and cholecystectomized patients

Agostino Di Ciaula, Emilio Molina-Molina, Leonilde Bonfrate, David Q.H. Wang, Dan L. Dumitrascu, Piero Portincasa

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Abstract

Background and aim: Several gallstone patients complain of dyspeptic symptoms, irrespective of the presence of typical colicky pain. Symptoms often persist after a cholecystectomy. Systematic studies on dyspepsia and dynamic gastrointestinal motor function are missing in gallstone patients with preserved gallbladder or after a cholecystectomy. Materials and methods: Forty-six gallstone patients (age 55 ± 2 years; 15M, 31F) and 24 cholecystectomized patients (age 57 ± 2 years; 6M, 18F) (no difference in type and volume of gallstones between the two groups) were compared against a group of 65 healthy controls (age 51 ± 2 years; 30M, 35F). Dyspepsia occurring in the prior months was assessed by a questionnaire, gastric and gallbladder emptying by functional ultrasonography and orocecal transit time by a hydrogen breath test using a lactulose-enriched standard liquid meal. Results: Gallstone patients had significantly greater dyspepsia, fasting and residual gallbladder volumes, and slower gallbladder emptying, gastric emptying and small intestinal transit time than controls. In cholecystectomized patients, gastric emptying further delayed, compared to gallstone patients and controls. Conclusion: Gallstone patients with the gallbladder “in situ” or after a cholecystectomy display dyspeptic symptoms. Symptoms are associated with multiple gastrointestinal motility defects involving the gallbladder, stomach and small intestine. After cholecystectomy, gastric emptying worsens.

Original languageEnglish (US)
Article numbere13066
JournalEuropean Journal of Clinical Investigation
Volume49
Issue number3
DOIs
StatePublished - Mar 2019

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Keywords

  • breath test
  • cholelithiasis
  • dyspepsia
  • motility
  • orocecal transit time
  • small intestine
  • ultrasonography

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

Cite this

Di Ciaula, A., Molina-Molina, E., Bonfrate, L., Wang, D. Q. H., Dumitrascu, D. L., & Portincasa, P. (2019). Gastrointestinal defects in gallstone and cholecystectomized patients. European Journal of Clinical Investigation, 49(3), [e13066]. https://doi.org/10.1111/eci.13066