Gallbladder bile composition in patients with Crohn＇s disease

AIM:To further elucidate the pathogenesis andmechanisms of the high risk of gallstone formation inCrohn's disease.METHODS:Gallbladder bile was obtained from patientswith Crohn's disease who were admitted for electivesurgery (17 with ileal/ileocolonic disease and 7 withCrohn's colitis).Fourteen gallstone patients servedas controls.Duodenal bile was obtained from tenhealthy subjects before and after the treatment withursodeoxycholic 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 wasabout 50% higher in patients with Crohn's disease thanin patients with cholesterol gallstones.Ten of the patientswith Crohn's disease involving ileum and three of thosewith Crohn's colitis had cholesterol saturated bile.Fourpatients with ileal disease and one of those with colonicdisease displayed cholesterol crystals in their bile.About1/3 of the patients with Crohn's disease had a shortCDT.Treatment of healthy subjects with ursodeoxycholicacid did not increase the concentration of bilirubin induodenal bile.Several patients with Crohn's disease,with or without ileal resection/disease had gallbladderbile supersaturated with cholesterol and short CDT andcontained cholesterol crystals.The biliary concentrationof bilirubin was also increased in patients with Crohn'scolitis probably not due to bile acid malabsorption.CONCLUSION:Several factors may be of importance forthe high risk of developing gallstones of both cholesteroland pigment types in patients with Crohn's disease.

Gallbladder bile composition in patients with Crohn 's disease

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.