Beneficial effect of sulphate-bicarbonate-calcium water on gallstone risk and weight control

AIM:To investigate the effect of drinking sulphate-bicarbonate-calcium thermal water (TW) on risk factors for atherosclerosis and cholesterol gallstone disease.METHODS:Postmenopausal women with functional dy-spepsia and/or constipation underwent a 12 d cycle of thermal (n=20) or tap (n=20) water controlled drinking.Gallbladder fasting volume at ultrasound,blood vitamin E,oxysterols (7-β-hydroxycholesterol and 7-ketocholesterol),bile acid (BA),triglycerides,total/low density lipoprotein and high density lipoprotein cholesterol were measured at baseline and at the end of the study.Food consumption,stool frequency and body weight were recorded daily.RESULTS:Blood lipids,oxysterols and vitamin E were not affected by either thermal or tap water consumption.Fasting gallbladder volume was significantly (P<0.005) smaller at the end of the study than at baseline in the TW (15.7±1.1 mL vs 20.1±1.7 mL) but not in the tap water group (19.0±1.4 mL vs 19.4±1.5 mL).Total serum BA concentration was significantly (P<0.05) higher at the end of the study than at baseline in the TW (5.83±1.24μmol vs 4.25±1.00μmol) but not in the tap water group (3.41±0.46μmol vs 2.91±0.56μmol).The increased BA concentration after TW consumption was mainly accounted for by glycochenodeoxycholic acid.The number of pasta (P<0.001),meat (P<0.001) and vegetable (P<0.005) portions consumed during the study and of bowel movements per day (P<0.05) were significantly higher in the TW than in the tap water group.Body weight did not change at the end of the study as compared to baseline in both groups.CONCLUSION:Sulphate-bicarbonate-calcium water consumption has a positive effect on lithogenic risk and intestinal transit and allows maintenance of a stable body weight despite a high food intake.

Prevalence of gallstone disease in first-degree relatives of patients with cholelithiasis

AIM: To evaluate the influence of familiality on the prevalence of gallstone disease (GD) in Italy.METHODS: Families of 79 subjects with gallstones (cases) and of 79 subjects without gallstones (controls)were investigated for the presence of gallstones by ultrasonography. Index cases and index controls were matched for age, sex, and operative unit. Sixty-three and sixty-two husbands and wives of index cases and index controls, respectively, were also studied.RESULTS: Overall,the prevalence of GD was significantly higher (X2=14.52, P＜0.001) in the 202 first-degree relatives of subjects with gallstones than that in the 201 first-degree relatives of subjects without gallstones (28.6% vs 12.4%, relative risk (RR) 1.80, 95% confidence interval (CI) 1.29-2.63). In particular,prevalence of GD was significantly higher in mothers,fathers, and sisters of index cases than that in the respective family members of index controls. The highest RR was observed in mothers (RR=2.35, 95%CI 1.38-4.3).Prevalence of GD was not obviously different in brothers and also in husbands and wives of index cases and index controls. Family members of index cases did not differ from family members of control cases with respect to the most important risk factors for gallstones (age, diabetes,BMI, and number of pregnancies) with an exception of a higher prevalence of diabetes in fathers of index controls than in fathers of index cases.CONCLUSION: This study confirms that familiality plays a very important role in the pathogenesis of gallstones.