Roles of gall bladder emptying and intestinal transit in the pathogenesis of octreotide induced gall bladder stones.

Hussaini, S. Hyder; Pereira, Stephen P.; Veysey, Martin; Kennedy, C; Jenkins, Paul J.; Murphy, Gérard M.; Wass, J. A. H.; Dowling, R. H.

doi:10.1136/gut.38.5.775

Cited by 70 publications

(46 citation statements)

References 48 publications

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“…The postulated carcinogen in this case is intralumenal bile acids which have undergone bacterial deconjugation in the right colon. These compounds, such as deoxycholic acid (DCA), have been strongly implicated in the development of sporadic colonic cancer and are increased in patients with acromegaly due in part to the prolonged colonic transit occurring in this condition (9). Thus, the increased IGF-I levels in acromegaly would increase the chances of survival of cells with damaged DNA in response to the elevated DCA levels, rather than the cells undergoing the normal protective apoptotic response.…”

Section: Evidence Implicating Igf-i In Cancermentioning

confidence: 99%

Evidence for a link between IGF-I and cancer

Jenkins

Bustin

2004

European Journal of Endocrinology

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Cancer risk is determined by a combination of environmental factors and genetic predisposition. Recent evidence suggests that dietary and related factors such as physical activity and body size may influence cancer risk through their effects on the serum concentration of IGF-I and its binding proteins. The growth hormone (GH)/IGF-I axis is involved in both human development as well as the maintenance of normal function and homeostasis in most cells of the body. In addition to their classical role as endocrine hormones, its members regulate a wide range of biological functions such as cell proliferation, differentiation and apoptosis through paracrine and autocrine mechanisms. During cancer development this complex network regulating tissue homeostasis breaks down, with inappropriate expression of the GH/IGF-I axis making an important contribution. The increased understanding of the molecular mechanisms and signalling pathways regulated by the GH/IGF-I axis has started to provide significant insights into the aetiology, prevention and therapy for a number of common cancers.European Journal of Endocrinology 151 S17-S22

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Section: Evidence Implicating Igf-i In Cancermentioning

confidence: 99%

Evidence for a link between IGF-I and cancer

Jenkins

Bustin

2004

European Journal of Endocrinology

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“…Resmini et al revealed prolonged oro-cecal transit time and small intestinal bacterial overgrowth in acromegaly patients [5], and Catnach et al found that gall bladder motor function was severely impaired in untreated acromegaly patients [17]. In another study reporting on gall bladder emptying and small intestinal transit in acromegaly patients, Hussaini et al showed that intestinal transit and gall bladder volume were significantly different between acromegaly patients and controls [18]. Our results contribute to previous studies by indicating motility abnormalities of the oesophagus and by suggesting that acromegaly could have unfavourable effects on oesophageal motility through the mechanisms of reduced percentage and duration of LES relaxation in patients without any clinical gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 98%

Akromegalia może wiązać się z zaburzeniami rozkurczu dolnego zwieracza przełyku (LES)

İlhan

Danalıoğlu

Turgut

et al. 2015

Endokrynologia Polska

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Introduction: Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients. Material and methods:The study was performed in an institutional referral centre at a tertiary care hospital. Twenty-three acromegaly patients (mean age 43.2 ± 13.2 years) and 25 sex-and age-matched healthy control subjects (mean age 48.6 ± 7.9 years) were recruited to a case-control study. Oesophageal manometry was performed using MMS (Medical Measurement Systems, Netherlands) Solar GI -Air Charged Intelligent Gastrointestinal Conventional Manometry. Results: In manometric measurements the lower oesophageal sphincter pressure was 18 ± 7 mmHg in acromegaly patients and 15.6 ± 4.4 mm Hg in controls, and there was no significant difference (p = 0.17). The percentage of relaxation was 64.8% and 81.8%, respectively, and it was significantly lower in acromegaly patients than in controls (p < 0.001). Additionally, the duration of relaxation was found to be 4 ± 1.9 seconds and 5 ± 1.7 seconds in patients and controls, respectively (p = 0.049). Conclusions:Our study has demonstrated a significant reduction in the percentage and duration of lower oesophageal sphincter relaxation in oesophagus motility even in acromegaly patients without any gastrointestinal symptoms. Further clinical and pathophysiological studies are required to clarify the underlying mechanisms of gastrointestinal motility disorders in acromegaly. (Endokrynol Pol 2015; 66 (4): 308-312)

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“…In the context of gallstones, small bowel transit time becomes progressively longer throughout pregnancy, eventually returning to normal after delivery (23). Impaired small bowel transit has been shown to be a factor in gallstone disease (22) and occurs during octoreotide therapy, which is known to induce gallstones (27,28). Prolonged large bowel transit has also been shown to be a factor in gallstone disease (29,30); however, studies of large bowel transit during pregnancy have produced conflicting results (23).…”

Section: Physiological Changes In the Biliarymentioning

confidence: 99%

“…It was also a factor in stone recurrence following dissolution (25). Other conditions inducing gallbladder stasis, such as parenteral alimentation (26) or octreotide therapy (27), were proven to be lithogenic. Impaired motility of the gastrointestinal tract: Pregnancy induces hypomotility throughout the gastrointestinal tract, probably via high progesterone levels.…”

Section: Physiological Changes In the Biliarymentioning

confidence: 99%

Pregnancy and the Biliary Tract

Gilat

Konikoff

1999

Canadian Journal of Gastroenterology and Hepatology

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Pregnancy induces many physiological changes, some of which may have pathological results. In population studies, gallstones were found in 6.5% to 8.4% of nulliparous women, and in 18.4% to 19.3% of women with two to three or more pregnancies. In women followed throughout pregnancy, neoformation of gallstones was documented in 3% to 8.1% depending on the population. Some 20% to 30% of these gallstones redissolve postpartum. The frequency of biliary colic during pregnancy is controversial, and the recommended therapeutic approach during pregnancy is conservative. When essential, invasive procedures are relatively well tolerated, preferably during the second trimester. Biliary sludge disappears postpartum in the great majority. Gallstones and sludge are most likely caused by biliary stasis, prolonged intestinal transit and increased cholesterol saturation of bile, which were all demonstrated to occur during pregnancy.

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Roles of gall bladder emptying and intestinal transit in the pathogenesis of octreotide induced gall bladder stones.

Cited by 70 publications

References 48 publications

Evidence for a link between IGF-I and cancer

Evidence for a link between IGF-I and cancer

Akromegalia może wiązać się z zaburzeniami rozkurczu dolnego zwieracza przełyku (LES)

Pregnancy and the Biliary Tract

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