Incidence and risk factors for gallstones in patients with inflammatory bowel disease: a large case-control study.
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 7.75 in matched controls (P=0.012) and 7.48/1000 persons/year in UC patients as compared with 6.06 in matched-controls (P=0.38). Ileo-colonic CD location (OR, 2.14), disease duration>15 years (OR, 4.26), >3 clinical recurrences (OR, 8.07), ileal resection>30 cm (OR, 7.03), >3 hospitalizations (OR, 20.7), multiple TPN treatments (OR, 8.07), and long hospital stay (OR, 24.8) were significantly related to GD in CD patients.


CONCLUSIONS
Only CD patients have a significantly higher risk of developing GD than well-matched hospital controls. Site of disease at diagnosis, lifetime surgery, extent of ileal resections, number of clinical recurrences, TPN, and the frequency and duration of hospitalizations are independently associated with GD.
Parente
Fabrizio
F
Gastrointestinal Unit, A. Manzoni Hospital, Lecco, and the Gastroenterology Unit, L. Sacco University Hospital, Milan, Italy. f.parente@ospedale.lecco.it
Pastore
Luca
L
Bargiggia
Stefano
S
Cucino
Claudia
C
Greco
Salvatore
S
Molteni
Mirko
M
Ardizzone
Sandro
S
Porro
Gabriele Bianchi
GB
Sampietro
Gianluca M
GM
Giorgi
Riccardo
R
Moretti
Roberto
R
Gallus
Silvano
S
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications* / Q000000981:diagnostic imaging; D003424:Crohn Disease / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014463:Ultrasonography