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Autonomic dysfunction and cholelithiasis in patients with cirrhosis
A Chawla1, L Puthumana, P J Thuluvath
1Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Digestive Diseases and Sciences
|April 25, 2001
Summary
Autonomic neuropathy may contribute to gallstone formation in advanced cirrhosis by impairing gallbladder emptying. This study found increased gallbladder disease in cirrhotic patients with autonomic neuropathy.
Area of Science:
- Gastroenterology
- Hepatology
- Neurology
Background:
- Gallstones affect 33-46% of cirrhosis patients, increasing with liver disease severity.
- Autonomic neuropathy, common in diabetics, impairs gallbladder emptying, suggesting a similar role in cirrhosis.
Purpose of the Study:
- To determine the prevalence of gallstones and gallbladder disease in cirrhotic patients with and without autonomic neuropathy.
Main Methods:
- Assessed autonomic function, gallstones, and gallbladder disease in 123 cirrhosis patients (Child A, B, C).
- Analyzed data based on autonomic neuropathy presence and liver disease severity.
Main Results:
- Gallstones were found in 54 patients; 22 had other gallbladder disease.
- Gallbladder disease prevalence was higher in patients with autonomic neuropathy (51% vs. 35%).
- In Child C cirrhosis, autonomic neuropathy correlated with increased gallstones (P=0.018) and gallbladder disease (P=0.03).
Conclusions:
- Autonomic neuropathy may contribute to gallstone formation in advanced cirrhosis.
- Impaired gallbladder and sphincter of Oddi motility due to neuropathy are potential mechanisms.