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Biliary function studies in patients with celiac sprue
The American Journal of Digestive Diseases
|February 1, 1977
Summary
Patients with celiac sprue exhibit reduced bilirubin output and impaired bile delivery to the duodenum. This biliary dysfunction exacerbates fat malabsorption, likely due to altered cholecystokinin-pancreozymin (CCK-PZ) regulation.
Area of Science:
- Gastroenterology
- Hepatobiliary Medicine
- Digestive Physiology
Background:
- Celiac sprue is associated with malabsorption, but biliary function alterations are not well understood.
- Impaired bile delivery can worsen fat malabsorption.
Purpose of the Study:
- To investigate basal biliary function and gallbladder response to small intestinal stimulation in celiac sprue patients.
- To determine the impact of impaired bile delivery on fat absorption in celiac sprue.
Main Methods:
- Assessed bilirubin output and gallbladder response to magnesium sulfate perfusion in 11 celiac sprue patients.
- Evaluated gallbladder function with intravenous cholecystokinin-pancreozymin (CCK-PZ) and common bile duct patency via intravenous cholangiography.
Main Results:
- Reduced basal bilirubin output observed.
- Magnesium sulfate did not stimulate gallbladder contraction.
- Complete lack of bile to the duodenum in 4/11 patients (basal) and 7/11 (digestive period).
- Normal gallbladder response to CCK-PZ and patent bile duct confirmed.
Conclusions:
- Celiac sprue patients exhibit significant bile delivery impairment.
- This biliary dysfunction likely exacerbates fat malabsorption.
- Altered synthesis or release of endogenous CCK-PZ may underlie the observed biliary dysfunction.