Commentary
See article on page 264Gall bladder and bowel: the links multiply
| The first 150 words of the full text of this article appear below. |
Penning et al's paper is a
brain-teaser (see page 264). It clearly shows is that, in the
laboratory, the gall bladder behaves abnormally in patients with
chronic constipation. What is much less clear, but very intriguing, is
what the findings mean. Recently, the state of the gall bladder in
patients with constipation has been attracting attention because of
growing evidence that cholesterol gallstones can result from slow
intestinal transit.1-3 Slow transit allows the colon to
absorb excessive amounts of bacterially degraded substances, including
the toxic bile acid, deoxycholic acid (DCA). When DCA reaches the
liver, it makes it secrete more cholesterol into bile and when it
reaches the gall bladder it hastens the crystallisation of
cholesterol.2 4 So, patients with slow transit
constipation should be at high risk of gallstones. Puzzle number one is
that the patients in Penning et al's study
seem to have escaped gallstones (although
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Relevant Article
- Gall bladder emptying in severe idiopathic constipation
- C Penning, H A J Gielkens, J B V M Delemarre, C B H W Lamers, and A A M Masclee
Gut 1999 45: 264-268.[Abstract] [Full Text] [PDF]
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