Gallbladder bile composition in patients with Crohn's disease

AIM： To further elucidate the pathogenesis and mechanisms of the high risk of gallstone formation in Crohn＇s disease. METHODS： Gallbladder bile was obtained from patients with Crohn＇s disease who were admitted for elective surgery （27 with ileal/ileocolonic disease and 7 with Crohn＇s colitis）. Fourteen gallstone patients served as controls. Duodenal bile was obtained from ten healthy subjects before and after the treatment with ursodeoxycholic acid. Bile was analyzed for biliary lipids, bile acids, bilirubin, crystals, and crystal detection time （CDT）. Cholesterol saturation index was calculated. RESULTS： The biliary concentration of bilirubin was about 50% higher in patients with Crohn＇s disease than in patients with cholesterol gallstones. Ten of the patients with Crohn＇s disease involving ileum and three of those with Crohn＇s colitis had cholesterol saturated bile. Four patients with ileal disease and one of those with colonic disease displayed cholesterol crystals in their bile. About 1/3 of the patients with Crohn＇s disease had a short CDT. Treatment of healthy subjects with ursodeoxycholic acid did not increase the concentration of bilirubin in duodenal bile. Several patients with Crohn＇s disease, with or without ileal resection/disease had gallbladder bile supersaturated with cholesterol and short CDT and contained cholesterol crystals. The biliary concentration of bilirubin was also increased in patients with Crohn＇s colitis probably not due to bile acid malabsorption. CONCLUSION： Several factors may be of importance for the high risk of developing gallstones of both cholesterol and pigment types in patients with Crohn＇s disease.The skillful technical assistance of Ms Lisbet Benthin and Ms Ingela Arvidsson is acknowledged.

瞄准：进一步阐明高度的致病和机制在 Crohn 的疾病胆石冒形成的风险。方法：胆囊胆汁与 Crohn 的疾病从病人被获得为选任的外科被招收(17 与 ileal/ileocolonic 疾病并且 7 与 Crohn 的大肠炎) 。十四个胆石病人用作控制。十二指肠的胆汁与 ursodeoxycholic 酸在治疗前后从十个健康题目被获得。胆汁为胆汁的类脂化合物，胆汁酸，胆红素，晶体，和水晶察觉时间(CDT ) 被分析。胆固醇浸透索引是计算的。结果：胆红素的胆汁的集中比在有胆固醇胆石的病人在有 Crohn 的疾病的病人更高是大约 50% 。有 Crohn 包含回肠的疾病的十个病人和三那些与 Crohn 的大肠炎把胆固醇浸透胆汁。与 i 一起的四个病人忠实疾病并且那些之一在他们的胆汁与结肠的疾病显示了胆固醇晶体。大约有 Crohn 的疾病的病人的 1/3 有短 CDT。有 ursodeoxycholic 酸的健康题目的治疗没在十二指肠的胆汁增加胆红素的集中。有 Crohn 的疾病的几个病人，与或没有 i 忠实切除术 / 疾病把胆囊胆汁与胆固醇和短 CDT 使过饱和并且包含了胆固醇晶体。胆红素的胆汁的集中也不由于胆汁酸吸收不良可能与 Crohn 的大肠炎在病人被增加。结论：几个因素可能具有为与 Crohn 的疾病在病人开发胆固醇和颜料类型的胆石的高风险的重要性。