Incidence and risk factors for gallstones in patients with inflammatory bowel disease

Abstract

The risk for gallstones (GD) in inflammatory bowel diseases and the factors responsible for this complication have not been well established. We studied the incidence of GD in a cohort of Crohn's disease (CD) and ulcerative colitis (UC) patients and investigated the related risk factors. A case-controlled study was carried out. The study population included 634 inflammatory bowel disease (IBD) patients (429 CD, 205 UC) and 634 age-matched, sex-matched, and body mass index (BMI)-matched controls free of GD at enrollment, who were followed for a mean of 7.2 years (range, 5-11 years).The incidence of GD was calculated by dividing the number of events per person-years of follow-up. Multivariate analysis was used to discriminate among the impact of different variables on the risk of developing GD. The incidence rates of GD were 14.35/1,000 persons/year in CD as compared with 7.

Crohn’s disease: prevalence of intestinal and extraintestinal manifestations detected by computed tomography enterography with water enema

“…Cholelithiasis is more common in individuals with CD than in the general population, and it is thought to be a result of terminal ileitis and decreased resorption of bile salts [33]. While sonography is the preferred imaging modality for the evaluation of cholelithiasis, gallstones can appear as either hyperattenuating or hypoattenuating filling defects within the gallbladder lumen at CT, depending on composition.…”

Gallstone disease: From genes to evidence-based therapy

“…Another potential pathway involves ileal disease or resection, causing spillage of bile salts into the colon, which promotes solubilization and absorption of unconjugated bilirubin and results in increased enterohepatic cycling and biliary secretion of bilirubin [49]. This mechanism might contribute to the high-gallstone prevalence rates in Crohn's disease [50] and cystic fibrosis [51]. Both in patients with hemolytic anemias and cystic fibrosis, the Gilbert syndrome-associated UGT1A1 promoter variant increases the susceptibility to pigment stone formation [52,53].…”

Hepatopancreatobiliary manifestations and complications associated with inflammatory bowel disease

“…152 Patients with CD had double the risk for gallstone development compared with matched IBD-free controls, while UC was not associated with an increased risk. 153 Age, disease location of CD at diagnosis, lifetime surgery, frequency of clinical recurrences, the extent of ileal resection, the length of hospital stay, and the use of total parenteral nutrition were reported to be associated with gallstones. 153 In addition, patients with CD were shown to have reduced gallbladder motility 154,155 and patients with ileal resection had reduced gallbladder emptying with fasting and total parenteral nutrition.…”

“…153 Age, disease location of CD at diagnosis, lifetime surgery, frequency of clinical recurrences, the extent of ileal resection, the length of hospital stay, and the use of total parenteral nutrition were reported to be associated with gallstones. 153 In addition, patients with CD were shown to have reduced gallbladder motility 154,155 and patients with ileal resection had reduced gallbladder emptying with fasting and total parenteral nutrition. 156 Therefore, multiple factors in CD patients may contribute to gallstone formation, including ileal resection with loss of bile salt reabsorption, supersaturation of bile, IBD-associated hospitalizations, and total parenteral nutrition.…”