Interactions between gall bladder bile and mucosa; relevance to gall stone formation

Article Abstract:

The gall bladder, a sac located close to the liver, is where liver bile is stored until it is propelled, by contraction of the gall bladder, into the intestines to aid in digestion. Gall stones are solid masses formed in the gall bladder from bile that is saturated with cholesterol. Researchers are beginning to recognize that a variety of other constituents of bile, as well as the interaction of these constituents with the mucosa (lining) of the gall bladder, play an important role in determining whether gallstones form. For example, calcium ions in the bile fluid stimulate the secretion of substances (mucus glycoproteins) that promote the precipitation of biliary calcium, a step that has been implicated in the formation of gallstones. Prostaglandins (inflammatory mediators), too, may play a crucial role in gall stone formation. Prostaglandins are potent stimulators of mucus secretion and gall bladder motility, as well as initiators of a number of biochemical pathways which produce a more dilute bile. Increased mucus secretion might be expected to increase the rate of gall stone formation, while gall bladder motility and dilute bile would tend to reduce stone formation. Hence, the observation that prostaglandin inhibitors can reduce gall stone formation implies that mucus secretion is an important promoter of the formation of gall stones. The gall bladder has evolved several mechanisms that act to reduce the likelihood of gall stone formation, including acidification of the bile, absorption of calcium by the mucosa, and the secretion of factors that reduce cholesterol and calcium precipitation. It will most likely be through therapeutic manipulation of the factors mediating gall stone formation that the most productive battles against gall bladder disease can be fought, rather than through surgical removal of gall stones or of the entire gall bladder. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Cholesterol, Digestion, Bile

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Persistence of symptoms after gall bladder clearance with cholecystolithotripsy

Article Abstract:

Gall stones are accumulations of deposits, often cholesterol-rich, in the gallbladder or bile ducts. Gall stones may remain asymptomatic, or in cases where the bile duct is blocked, may cause extreme pain and flatulence. A popular method for treating gall stones is cholecystolithotripsy, the application of focused shock waves to the area of the gall bladder. This causes the gall stones to disintegrate, but does not harm the surrounding soft tissue. To characterize the degree to which symptoms persist following successful clearance of stones from the gall bladder and biliary system with cholecystolithotripsy, 46 patients were monitored with serial ultrasound over a period of 2 to 25 months following the procedure. Cholecystolithotripsy alone was employed, without concurrent administration of chemolitholytic agents (orally administered agents to facilitate gall stone dissolution). Seven patients (six of whom remain asymptomatic) developed recurrent gall stones. Of the 39 stone-free patients, six complained of continuing pain similar to that experienced prior to cholecystolithotripsy; only one of these patients had recurrent stone formation. Seven patients complained of a variety of symptoms that did not seem to be related to the gall bladder or biliary system. The overall 30 percent incidence of continuing abdominal symptoms is quite similar to what is reported following cholecystectomy (surgical removal of the gall bladder). (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Surgery, Ultrasonic lithotripsy, Gallbladder

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Gall stones in a Danish population. Relation to weight, physical activity, smoking, coffee consumption, and diabetes mellitus

Article Abstract:

The presence of gallstones was assessed in relation to several factors, including weight, physical activity, smoking, coffee consumption, and diabetes mellitus. In women, the incidence of gallstones was significantly related to obesity, history of weight-loss treatment, and substantial weight gain since the age of 25. In a multi-variable analysis, where more than one factor was studied, only the obesity index was significant. In men, the presence of gallstones was related to history of slimming treatment in both single and multi-variable analyses. Smoking was also significantly associated with gallstones. The other variables did not significantly affect the incidence of gallstones.

Health aspects, Complications and side effects, Reducing diets, Diabetes, Diabetes mellitus, Obesity, Smoking, Exercise, Exercise physiology

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