title: Slow gallbladder emptying reverts to normal but small intestinal transit of a physiological meal remains slow in celiac patients during gluten-free diet.
abstract: BACKGROUND
  Alterations of small intestinal transit and gallbladder (GB) motility have been reported in celiac disease (CD) in studies involving, in most cases, non-physiological experimental conditions and artificial stimuli to motility. Our aims were to quantitate non-invasively small intestinal transit time and GB emptying during administration of a physiological and palatable solid meal, and to assess the effect of gluten-free diet (GFD).
  
  
  METHODS
  We simultaneously measured mouth-to-cecum transit time (MCTT) using a validated H(2) breath test, and GB motility using ultrasonography. We studied CD patients before (n = 19) and during (n = 14) GFD, and healthy volunteers (n = 24) following administration of a physiological solid meal (Kcal 539).
  
  
  RESULTS
  Mouth-to-cecum transit time was more prolonged in CD (mean ± SEM: 235 ± 96 min) than in controls (169 ± 65 min, P = 0.0039). The GB fasting volume and postprandial residual volume were significantly higher in CD than in controls, and GB emptying constant was slower in CD than in controls. During GFD, GB emptying reverted to normal, but MCTT remained unchanged (229 ± 69 min) and more prolonged in CD than in controls (P = 0.0139). During GFD, duodenal infiltration with lymphocytes and mast cells persisted higher than that in controls, and the number of mast cells lying in proximity of nervous endings did not change.
  
  
  CONCLUSIONS
  Slow postprandial MCTT in response to a physiological meal does not revert to normal during GFD, an effect mirroring incomplete histopathologic recovery.
authors.affiliation: Gastroenterology Unit and Histopathology Unit, University and Spedali Civili of Brescia, Brescia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Benini
authors.forename: A
authors.initials: A
authors.lastname: Mora
authors.forename: D
authors.initials: D
authors.lastname: Turini
authors.forename: S
authors.initials: S
authors.lastname: Bertolazzi
authors.forename: F
authors.initials: F
authors.lastname: Lanzarotto
authors.forename: C
authors.initials: C
authors.lastname: Ricci
authors.forename: V
authors.initials: V
authors.lastname: Villanacci
authors.forename: G
authors.initials: G
authors.lastname: Barbara
authors.forename: V
authors.initials: V
authors.lastname: Stanghellini
authors.forename: A
authors.initials: A
authors.lastname: Lanzini
mesh_terms: D000293:Adolescent; D000328:Adult; D001944:Breath Tests; D002446:Celiac Disease / Q000178:diet therapy / Q000503:physiopathology*; D055050:Diet, Gluten-Free; D005260:Female; D005704:Gallbladder / Q000503:physiopathology*; D016473:Gallbladder Emptying / Q000502:physiology*; D005746:Gastric Emptying / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period