Intest Res.  2015 Apr;13(2):122-127. 10.5217/ir.2015.13.2.122.

Increased Risk of Asymptomatic Gallstones in Patients With Ulcerative Colitis

Affiliations
  • 1Department of Gastroenterology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea. pys1109@eulji.ac.kr
  • 2Department of Family Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
  • 3Department of Radiology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea.
  • 4Department of Gastroenterology, Ajou University College of Medicine, Suwon, Korea.

Abstract

BACKGROUND/AIMS
The relationship between Crohn's disease and gallstones is established. However, the prevalence and risk factors for gallstones in patients with ulcerative colitis (UC) are not yet well understood. The aim of this study was to evaluate the prevalence and risk factors of gallstones in patients with UC.
METHODS
This study was a retrospective single center study. A total of 87 patients with UC and 261 healthy controls were enrolled. Age, sex, and body mass index were matched. To investigate risk factors, the extent of UC, duration of disease, number of hospital admissions, and number of steroid treatments in patients with UC were evaluated.
RESULTS
The prevalence of gallstones in patients with UC was 13.8%, whereas that in healthy controls was only 3.1% (P<0.001). For patients with UC, patients > or =50 years of age had a 3.6-times higher risk of gallstones compared to that in those <50 years of age, and the difference was statistically significant (odds ratio, 3.60; confidence interval, 1.03-12.61) in univariate analysis. There were no statistically significant disease-related risk factors for gallstones in UC patients.
CONCLUSIONS
This is the first study of gallstone prevalence in Korean UC patients. In this study, patients with UC had a higher prevalence of gallstones compared to that in well-matched healthy controls. Age seemed to be a possible risk factor, and more studies are needed. Further prospective, large-scale studies will be required to confirm the risk factors for gallstones in UC patients.

Keyword

Asymptomatic disease; Colitis, ulcerative; Gallstones; Prevalence; Risk factors

MeSH Terms

Asymptomatic Diseases
Body Mass Index
Colitis, Ulcerative*
Crohn Disease
Gallstones*
Humans
Prevalence
Retrospective Studies
Risk Factors

Reference

1. Heaton KW, Read AE. Gall stones in patients with disorders of the terminal ileum and disturbed bile salt metabolism. Br Med J. 1969; 3:494–496. PMID: 5805332.
Article
2. Baker AL, Kaplan MM, Norton RA, Patterson JF. Gallstones in inflammatory bowel disease. Am J Dig Dis. 1974; 19:109–112. PMID: 4811164.
Article
3. 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. PMID: 6383747.
Article
4. 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. PMID: 2202567.
5. Kangas E, Lehmusto P, Matikainen M. Gallstones in Crohn's disease. Hepatogastroenterology. 1990; 37:83–84. PMID: 2312044.
6. Lapidus A, Bangstad M, Astrom M, Muhrbeck O. The prevalence of gallstone disease in a defined cohort of patients with Crohn's disease. Am J Gastroenterol. 1999; 94:1261–1266. PMID: 10235204.
Article
7. Bargiggia S, Maconi G, Elli M, et al. Sonographic prevalence of liver steatosis and biliary tract stones in patients with inflammatory bowel disease: study of 511 subjects at a single center. J Clin Gastroenterol. 2003; 36:417–420. PMID: 12702985.
Article
8. Keulemans YC, Mok KS, Slors JF, et al. Concanavalin A-binding cholesterol crystallization inhibiting and promoting activity in bile from patients with Crohn's disease compared to patients with ulcerative colitis. J Hepatol. 1999; 31:685–691. PMID: 10551393.
Article
9. Chung YJ, Park YD, Lee HC, et al. Prevalence and risk factors of gallstones in a general health screened population. Korean J Med. 2007; 72:480–490.
10. Chang YR, Jang JY, Kwon W, et al. Changes in demographic features of gallstone disease: 30 years of surgically treated patients. Gut Liver. 2013; 7:719–724. PMID: 24312714.
Article
11. Lee JK, Rhee PL, Lee JH, et al. Prevalence and risk factors of gallstone in health screening people. Korean J Gastroenterol. 1997; 29:85–92.
12. Stender S, Nordestgaard BG, Tybjaerg-Hansen A. Elevated body mass index as a causal risk factor for symptomatic gallstone disease: a Mendelian randomization study. Hepatology. 2013; 58:2133–2141. PMID: 23775818.
Article
13. Kalser SC. National Institutes of Health consensus development conference statement on gallstones and laparoscopic cholecystectomy. Am J Surg. 1993; 165:390–396. PMID: 8480870.
Article
14. Shaffer EA. Gallstone disease: epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006; 20:981–996. PMID: 17127183.
15. Yi SY, Lee SK, Kim JW, et al. Clinical study on gallstone prevalence in general health screening people. Korean J Med. 1994; 47:352–358.
16. Parente F, Pastore L, Bargiggia S, et al. Incidence and risk factors for gallstones in patients with inflammatory bowel disease: a large case-control study. Hepatology. 2007; 45:1267–1274. PMID: 17464998.
Article
17. Liddle RA, Goldstein RB, Saxton J. Gallstone formation during weight-reduction dieting. Arch Intern Med. 1989; 149:1750–1753. PMID: 2669662.
Article
18. Shiffman ML, Sugerman HJ, Kellum JM, Brewer WH, Moore EW. Gallstone formation after rapid weight loss: a prospective study in patients undergoing gastric bypass surgery for treatment of morbid obesity. Am J Gastroenterol. 1991; 86:1000–1005. PMID: 1858735.
19. Al-Jiffry BO, Shaffer EA, Saccone GT, Downey P, Kow L, Toouli J. Changes in gallbladder motility and gallstone formation following laparoscopic gastric banding for morbid obestity. Can J Gastroenterol. 2003; 17:169–174. PMID: 12677265.
Article
20. Weinsier RL, Wilson LJ, Lee J. Medically safe rate of weight loss for the treatment of obesity: a guideline based on risk of gallstone formation. Am J Med. 1995; 98:115–117. PMID: 7847427.
Article
21. Syngal S, Coakley EH, Willett WC, Byers T, Williamson DF, Colditz GA. Long-term weight patterns and risk for cholecystectomy in women. Ann Intern Med. 1999; 130:471–477. PMID: 10075614.
Article
22. Constantinescu T, Huwood Al Jabouri AK, Brãtucu E, Olteanu C, Toma M, Stoiculescu A. Gallstone disease in young population: incidence, complications, therapeutic approach. Chirurgia (Bucur). 2012; 107:579–582. PMID: 23116830.
23. Leitzmann MF, Giovannucci EL, Rimm EB, et al. The relation of physical activity to risk for symptomatic gallstone disease in men. Ann Intern Med. 1998; 128:417–425. PMID: 9499324.
Article
24. Leitzmann MF, Rimm EB, Willett WC, et al. Recreational physical activity and the risk of cholecystectomy in women. N Engl J Med. 1999; 341:777–784. PMID: 10477775.
Article
25. Heaton KW. Disturbances of bile acid metabolism in intestinal disease. Clin Gastroenterol. 1977; 6:69–89. PMID: 330053.
Article
26. Dowling RH, Bell GD, White J. Lithogenic bile in patients with ileal dysfunction. Gut. 1972; 13:415–420. PMID: 5040830.
Article
27. Marks JW, Conley DR, Capretta TL, et al. Gallstone prevalence and biliary lipid composition in inflammatory bowel disease. Am J Dig Dis. 1977; 22:1097–1100. PMID: 930909.
Article
28. Jones MR, Gregory D, Evans KT, Rhodes J. The prevalence of gallbladder disease in patients with ileostomy. Clin Radiol. 1976; 27:561–562. PMID: 1000901.
Article
29. Kurchin A, Ray JE, Bluth EI, et al. Cholelithiasis in ileostomy patients. Dis Colon Rectum. 1984; 27:585–588. PMID: 6468196.
Article
30. Kratzer W, Haenle MM, Mason RA, von Tirpitz C, Kaechele V. Prevalence of cholelithiasis in patients with chronic inflammatory bowel disease. World J Gastroenterol. 2005; 11:6170–6175. PMID: 16273645.
Article
31. Fraquelli M, Losco A, Visentin S, et al. Gallstone disease and related risk factors in patients with Crohn disease: analysis of 330 consecutive cases. Arch Intern Med. 2001; 161:2201–2204. PMID: 11575976.
Article
32. Choi CH, Kim YH, Kim YS, et al. Guidelines for the management of ulcerative colitis. Intest Res. 2012; 10:1–25.
Article
33. Lin J, Shen B, Lee HJ, Goldblum JR. Histopathological characterization of cholecystectomy specimens in patients with inflammatory bowel disease. J Crohns Colitis. 2012; 6:895–899. PMID: 22397872.
Article
34. Sarva RP, Farivar S, Fromm H, Poller W. Study of the sensitivity and specificity of computerized tomography in the detection of calcified gallstones which appears radiolucent by conventional roentgenography. Gastrointest Radiol. 1981; 6:165–167. PMID: 7250631.
Article
35. Hickman MS, Schwesinger WH, Bova JD, Kurtin WE. Computed tomographic analysis of gallstones. An in vitro study. Arch Surg. 1986; 121:289–291. PMID: 3947228.
Full Text Links
  • IR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr