Misoprostol induces gallbladder contraction during fasting, but does not influence postprandial emptying: an ultrasound study in healthy subjects.
OBJECTIVE
The aim of this study was to evaluate the effect of the PGE1 analogue, Misoprostol, on gallbladder fasting volume and meal-stimulated emptying. Prostaglandins' effects on the gallbladder were studied principally regarding mucus production during lithogenesis. In the few in vitro and in vivo studies, contradictory results concerning their influence upon gallbladder motility were obtained.


METHODS
13 healthy subjects, 8 females, 5 males, aged 23.4 years (ranges 22-25).


METHODS
Gallbladder volumes were assessed by ultrasound, after measuring the three diameters of the gallbladder in two perpendicular planes, using a conventional 2D equipment and a 3D equipment, after the 3D-reconstruction of the gallbladder. The volumes were calculated by means of the ellipsoid formula. Gallbladder emptying variables (residual volume, ejection fraction, area under emptying curve) were assessed during 90 minutes after a test meal (14 g fat, 425 kcal). Gallbladder emptying was evaluated in each subject on three different days: without prior Misoprostol administration, after 200 mg Misoprostol, and after 400 mg Misoprostol. Misoprostol was given orally as a single dose, 60 minutes before the meal. The two-tailed Student's t test for paired observations was used to compare the results.


RESULTS
Misoprostol induced a significant decrease of the gallbladder fasting volume: from 12.8 +/- 4.4 (SD) ml (controls) to 9.1 +/- 3.6 ml (200 mg Misoprostol) and 5.4 +/- 2.6 ml (400 mg Misoprostol). Gallbladder meal-stimulated emptying was not influenced by Misoprostol.


CONCLUSIONS
Our results indicated that, in healthy subjects, misoprostol induced a dose-dependent gallbladder emptying in the fasting state, but did not influence gallbladder postprandial emptying. Pre-prandial Misoprostol administration might be useful to treat gallbladder stasis in patients with chronic constipation, thus preventing gallstone formation.
Acalovschi
Monica
M
3rd Medical Clinic, University of Medicine and Pharmacy, Str. Iuliu Maniu no. 9, 3400 Cluj-Napoca, Romania.
Dumitrascu
Dan L
DL
Suteu
Titus
T
Veres
Adina
A
Albu
Sergiu
S
Badea
Radu I
RI
D000328:Adult; D005215:Fasting / Q000502:physiology; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology*; D016473:Gallbladder Emptying / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D016595:Misoprostol / Q000494:pharmacology*; D019518:Postprandial Period / Q000502:physiology; D014463:Ultrasonography
D016595:Misoprostol