Effect of Cholecystectomy on Gastric and Esophageal Bile Reflux in Patients with Upper Gastrointestinal Symptoms

Fein, Martin; Bueter, Marco; Sailer, M.; Kh, Fuchs

doi:10.1007/s10620-007-9989-8

Cited by 18 publications

(12 citation statements)

References 39 publications

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“…A literature also showed that post-cholecystectomy patients had a predominance of epigastric pain and thoracic pain, and also a trend for nausea, and bloating. 24 We hypothesize that the substrate of stomach, which flows backward from the small intestine due to duodenogastric reflux, reflects dominant upper GI symptoms in post-cholecystectomy patients.…”

Section: Discussionmentioning

confidence: 99%

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Sung

Paik

Chung

et al. 2015

J Neurogastroenterol Motil

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Background/AimsPatients undergoing cholecystectomy may have small intestinal bacterial overgrowth (SIBO). We investigated the prevalence and characteristics of SIBO in patients with intestinal symptoms following cholecystectomy. MethodsSixty-two patients following cholecystectomy, 145 with functional gastrointestinal diseases (FGIDs), and 30 healthy controls undergoing hydrogen (H2)-methane (CH4) glucose breath test (GBT) were included in the study. Before performing GBT, all patients were interrogated using bowel symptom questionnaire. The positivity to GBT indicating the presence of SIBO, gas types and bowel symptoms were surveyed. ResultsPost-cholecystectomy patients more often had SIBO as evidenced by a positive (+) GBT than those with FGID and controls (29/62, 46.8% vs 38/145, 26.2% vs 4/30, 13.3%, respectively; P = 0.010). In the gas types, the GBT (H2) + post-cholecystectomy patients was significantly higher than those in FGIDs patients (P = 0.017). Especially, positivity to fasting GBT (H2) among the GBT (H2)+ post-cholecystectomy patients was high, as diagnosed by elevated fasting H2 level. The GBT+ group had higher symptom scores of significance or tendency in abdominal discomfort, bloating, chest discomfort, early satiety, nausea, and tenesmus than those of the GBT negative group. The status of cholecystectomy was the only significant independent factor for predicting SIBO. ConclusionsThe SIBO with high levels of baseline H2 might be the important etiologic factor of upper GI symptoms for post-cholecystectomy patients. (J Neurogastroenterol Motil 2015;21:545-551)

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Section: Discussionmentioning

confidence: 99%

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Sung

Paik

Chung

et al. 2015

J Neurogastroenterol Motil

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“…It has been suggested that both gallstones and previous cholecystectomy contribute to the occurrence of duodeno-gastric reflux [16,[34][35][36][37][38][39]. The underlying mechanism is thought to be a dysfunction of the antroduodenal motor unit that favors the reflux of duodenal contents into the stomach [37].…”

Section: Discussionmentioning

confidence: 99%

Gallstones increase the prevalence of Barrett’s esophagus

et al. 2009

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“…Recently Fein and co-workers did not detect any differences of DGER in cholecystectomized patients. Therefore, we have re-evaluated this question [22]. Here, we examine effect of CCE on DGER in symptomatic GERD patients.…”

Section: Discussionmentioning

confidence: 99%

Increased Duodeno-Gastro-Esophageal Reflux (DGER) in Symptomatic GERD Patients with a History of Cholecystectomy

Kunsch

Neeße²,

Huth³

et al. 2009

Z Gastroenterol

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Zusammenfassung ! Grundlagen: Der duodeno-gastro-ösophageale Reflux (DGER) wird als unabhängiger Risikofaktor für die Entstehung einer komplizierten gastro-öso-phagealen Refluxerkrankung (GERD) angesehen. Sowohl klinische als auch epidemiologische Daten lassen vermuten, dass eine Cholezystektomie (CCE) das Ausmaß eines DGER beeinflussen könnte. Methoden: 132 Patienten (67 Frauen, 65 Männer, Altersmedian 55) mit typischen klinischen Beschwerden einer GERD wurden in die Studie eingeschlossen. Die Patienten wurden unterteilt in cholezystektomiert (CCE-Gruppe, n = 25) und nicht cholezystektomiert (nCCE-Gruppe, n = 107). Die standardisiert durchgeführte Diagnostik beinhaltete eine 24-h-pH-Metrie mit Bilitec 2000 und Ösophagusmanometrie sowie eine Ösophago-gastro-Duodenoskopie. Ergebnisse: Die statistische Analyse erbrachte keine signifikanten Unterschiede weder in Quantität noch Qualität von Refluxsymptomen zwischen den Patienten mit und ohne Cholezystektomie. Weitergehend unterschied sich die CCE-Gruppe weder in dem Ausmaß des sauren Refluxes noch in dem Auftreten oder der Schwere einer Refluxösophagitis von der nCCE-Gruppe. Jedoch wies die CCE-Gruppe einen signifikant höheren Prozentsatz von Patienten mit einem pathologisch gesteigerten DGER im Vergleich zu der nCCE-Gruppe auf (76 vs. 55%, p < 0,01). Entsprechend zeichnete sich die CCE-Gruppe durch einen signifikant höheren DGERD im Vergleich zu der nCCE-Gruppe aus (15,5% ± 14,1 vs. 8,6% ± 15,4; p < 0,05). Schlussfolgerung: In der hier vorgestellten Studie konnte erstmals der potenzielle Einfluss einer Cholezystektomie auf das Ausmaß des DGER in Patienten mit klinischen Symptomen einer Refluxerkrankung unter Verwendung des Bilitec 2000 gezeigt werden. Sowohl die Frequenz als auch das Ausmaß des DGER waren in der CCEAbstract ! Backgrounds: Duodenal-Gastro-Esophageal Reflux (DGER) represents an independent risk factor for the development of complicated Gastro-esophageal-reflux-disease (GERD) and Barrett's esophagus. Clinical and epidemiological data suggest a potential association between cholecystectomy (CCE) and augmented bile reflux. Methods: 132 patients (67 women, 65 men, median age 55) with typical symptoms of GERD were enrolled in the study and divided in cholecystectomized (CCE-group: n = 107) and noncholecystectomized (nCCE-group: n = 25) patients. Standardized clinical work-up of patients included combined esophageal 24 h pH-measurement and Bilitec 2000 esophageal manometry and upper endoscopy. Results: In the statistical analysis no differences between the cholecystectomized group (CCEgroup, n = 25) and the patients without cholecystectomy (nCCE-group, n = 107) could be observed in quantity or quality of reflux symptoms. Furthermore, neither acid reflux nor severity of inflammation and frequency of Barrett's esophagus significantly differed between the nCCE and CCEgroup. However, the percentage of patients with pathological DGER were significantly higher in the CCE-group as compared to the nCCE-group (76 vs. 55%, p < 0.01). Moreover, the CCE-group revealed ...

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Effect of Cholecystectomy on Gastric and Esophageal Bile Reflux in Patients with Upper Gastrointestinal Symptoms

Cited by 18 publications

References 39 publications

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Small Intestinal Bacterial Overgrowth Diagnosed by Glucose Hydrogen Breath Test in Post-cholecystectomy Patients

Gallstones increase the prevalence of Barrett’s esophagus

Increased Duodeno-Gastro-Esophageal Reflux (DGER) in Symptomatic GERD Patients with a History of Cholecystectomy

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