Gallbladder motility and cholecystokinin release during long-term enteral nutrition in patients with Crohn's disease.
BACKGROUND
Gallbladder bile stasis during long-term continuous enteral feeding may contribute to the high prevalence of gallstones in patients with Crohn's disease. We therefore examined the effects of continuous enteral nutrition on gallbladder motility and cholecystokinin (CCK) release in six patients.


METHODS
Gallbladder volume was measured ultrasonographically for 12 h on days 1 (start), 8, 22 (6-h interruption of enteral feeding), 36, and 43 (end) of enteral feeding. Plasma CCK was assessed at several time points.


RESULTS
Initial fasting gallbladder volume was 19.3 +/- 4.5 (mean +/- SEM) ml, which decreased to 4.9 +/- 3.6 ml after start of feeding. CCK increased from 1.5 +/- 0.3 to 3.9 +/- 1.1 pmol/l. On days 8 and 36 the gallbladder was almost completely contracted, and CCK increased to 7.5 +/- 2.7 and 8.3 +/- 2.6 pmol/l, respectively. On days 22 and 43 gallbladder volume increased, and CCK decreased rapidly to fasting concentrations after interruption of feeding.


CONCLUSIONS
During continuous enteral nutrition the gallbladder is completely contracted, and CCK concentrations remain elevated. It is therefore unlikely that long-term enteral nutrition contributes to the increased prevalence of gallstones in patients with Crohn's disease.
Dept. of Gastroenterology, University Hospital, Nijmegen, The Netherlands.
M F
MF
Stolk
K J
KJ
Van Erpecum
G
G
Hiemstra
J B
JB
Jansen
G P
GP
Van Berge-Henegouwen
D000293:Adolescent; D000328:Adult; D002766:Cholecystokinin / Q000097:blood*; D003424:Crohn Disease / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D004750:Enteral Nutrition; D005215:Fasting; D005260:Female; D016473:Gallbladder Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D013997:Time Factors
D002766:Cholecystokinin