Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults

Piero Portincasa, Antonio Moschetta, Massimo Berardino, Agostino Di Ciaula, Michele Vacca, Giuseppe Baldassarre, Anna Pietrapertosa, Rosario Cammarota, Nunzia Tannoia, Giuseppe Palasciano

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Aim: Gallbladder and gastrointestinal motility defects exist in gallstones patients and to a lesser extent in pigment gallstone patients. To investigated the role of gallbladder and gastrointestinal motility disorders in pigment gallstone formation in β-thalassemia major. Methods: Twenty-three patients with β-thalassemia major (16 females; age range 18-37 years) and 70 controls (47 females, age range 18-40 years) were studied for gallbladder and gastric emptying (functional ultrasonography), orocecal transit (OCTT, H2-breath test), autonomic dysfunction (sweat-spot, cardiorespiratory reflex tests), bowel habits, gastrointestinal symptoms and quality of life (all with questionnaires). Gallbladder content (ultrasonography) was examined before and during 8-12 mo follow-up. Results: Gallstones and/or biliary sludge were found in 13 (56%) patients. β-thalassemia major patients had increased fasting (38.0±4.8 mL vs 20.3±0.7 mL, P = 0.0001) and residual (7.9±1.3 mL vs 5.1±0.3 mL, P = 0.002) volume and slightly slower emptying (24.9±1.7 min vs 20.1±0.7 min, P = 0.04) of the gallbladder, together with longer OCTT (132.2±7.8 min vs 99.7±2.3 min, P = 0.00003) than controls. No differences in gastric emptying and bowel habits were found. Also, patients had higher dyspepsia (score: 6.7±1.2 vs 4.9±0.2, P = 0.027), greater appetite (P = 0.000004) and lower health perception (P = 0.00002) than controls. Autonomic dysfunction was diagnosed in 52% of patients (positive tests: 76.2% and 66.7% for parasympathetic and sympathetic involvement, respectively). Patients developing sludge during follow-up (38%, 2 with prior stones) had increased fasting and residual gallbladder volume. Conclusion: Adult β-thalassemia major patients have gallbladder dysmotility associated with delayed small intestinal transit and autonomic dysfunction. These abnormalities apparently contribute together with haemolytic hyperbilirubinemia to the pathogenesis of pigment gallstones/ sludge in β-thalassemia major.

Original languageEnglish
Pages (from-to)2383-2390
Number of pages8
JournalWorld Journal of Gastroenterology
Volume10
Issue number16
Publication statusPublished - Aug 15 2004

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beta-Thalassemia
Gallstones
Gallbladder
Bile
Gastrointestinal Motility
Gastric Emptying
Sewage
Habits
Fasting
Ultrasonography
Gallbladder Emptying
Breath Tests
Residual Volume
Hyperbilirubinemia
Sweat
Dyspepsia
Appetite
Reflex
Quality of Life
Health

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Portincasa, P., Moschetta, A., Berardino, M., Di Ciaula, A., Vacca, M., Baldassarre, G., ... Palasciano, G. (2004). Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults. World Journal of Gastroenterology, 10(16), 2383-2390.

Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults. / Portincasa, Piero; Moschetta, Antonio; Berardino, Massimo; Di Ciaula, Agostino; Vacca, Michele; Baldassarre, Giuseppe; Pietrapertosa, Anna; Cammarota, Rosario; Tannoia, Nunzia; Palasciano, Giuseppe.

In: World Journal of Gastroenterology, Vol. 10, No. 16, 15.08.2004, p. 2383-2390.

Research output: Contribution to journalArticle

Portincasa, P, Moschetta, A, Berardino, M, Di Ciaula, A, Vacca, M, Baldassarre, G, Pietrapertosa, A, Cammarota, R, Tannoia, N & Palasciano, G 2004, 'Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults', World Journal of Gastroenterology, vol. 10, no. 16, pp. 2383-2390.
Portincasa, Piero ; Moschetta, Antonio ; Berardino, Massimo ; Di Ciaula, Agostino ; Vacca, Michele ; Baldassarre, Giuseppe ; Pietrapertosa, Anna ; Cammarota, Rosario ; Tannoia, Nunzia ; Palasciano, Giuseppe. / Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults. In: World Journal of Gastroenterology. 2004 ; Vol. 10, No. 16. pp. 2383-2390.
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abstract = "Aim: Gallbladder and gastrointestinal motility defects exist in gallstones patients and to a lesser extent in pigment gallstone patients. To investigated the role of gallbladder and gastrointestinal motility disorders in pigment gallstone formation in β-thalassemia major. Methods: Twenty-three patients with β-thalassemia major (16 females; age range 18-37 years) and 70 controls (47 females, age range 18-40 years) were studied for gallbladder and gastric emptying (functional ultrasonography), orocecal transit (OCTT, H2-breath test), autonomic dysfunction (sweat-spot, cardiorespiratory reflex tests), bowel habits, gastrointestinal symptoms and quality of life (all with questionnaires). Gallbladder content (ultrasonography) was examined before and during 8-12 mo follow-up. Results: Gallstones and/or biliary sludge were found in 13 (56{\%}) patients. β-thalassemia major patients had increased fasting (38.0±4.8 mL vs 20.3±0.7 mL, P = 0.0001) and residual (7.9±1.3 mL vs 5.1±0.3 mL, P = 0.002) volume and slightly slower emptying (24.9±1.7 min vs 20.1±0.7 min, P = 0.04) of the gallbladder, together with longer OCTT (132.2±7.8 min vs 99.7±2.3 min, P = 0.00003) than controls. No differences in gastric emptying and bowel habits were found. Also, patients had higher dyspepsia (score: 6.7±1.2 vs 4.9±0.2, P = 0.027), greater appetite (P = 0.000004) and lower health perception (P = 0.00002) than controls. Autonomic dysfunction was diagnosed in 52{\%} of patients (positive tests: 76.2{\%} and 66.7{\%} for parasympathetic and sympathetic involvement, respectively). Patients developing sludge during follow-up (38{\%}, 2 with prior stones) had increased fasting and residual gallbladder volume. Conclusion: Adult β-thalassemia major patients have gallbladder dysmotility associated with delayed small intestinal transit and autonomic dysfunction. These abnormalities apparently contribute together with haemolytic hyperbilirubinemia to the pathogenesis of pigment gallstones/ sludge in β-thalassemia major.",
author = "Piero Portincasa and Antonio Moschetta and Massimo Berardino and {Di Ciaula}, Agostino and Michele Vacca and Giuseppe Baldassarre and Anna Pietrapertosa and Rosario Cammarota and Nunzia Tannoia and Giuseppe Palasciano",
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T1 - Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults

AU - Portincasa, Piero

AU - Moschetta, Antonio

AU - Berardino, Massimo

AU - Di Ciaula, Agostino

AU - Vacca, Michele

AU - Baldassarre, Giuseppe

AU - Pietrapertosa, Anna

AU - Cammarota, Rosario

AU - Tannoia, Nunzia

AU - Palasciano, Giuseppe

PY - 2004/8/15

Y1 - 2004/8/15

N2 - Aim: Gallbladder and gastrointestinal motility defects exist in gallstones patients and to a lesser extent in pigment gallstone patients. To investigated the role of gallbladder and gastrointestinal motility disorders in pigment gallstone formation in β-thalassemia major. Methods: Twenty-three patients with β-thalassemia major (16 females; age range 18-37 years) and 70 controls (47 females, age range 18-40 years) were studied for gallbladder and gastric emptying (functional ultrasonography), orocecal transit (OCTT, H2-breath test), autonomic dysfunction (sweat-spot, cardiorespiratory reflex tests), bowel habits, gastrointestinal symptoms and quality of life (all with questionnaires). Gallbladder content (ultrasonography) was examined before and during 8-12 mo follow-up. Results: Gallstones and/or biliary sludge were found in 13 (56%) patients. β-thalassemia major patients had increased fasting (38.0±4.8 mL vs 20.3±0.7 mL, P = 0.0001) and residual (7.9±1.3 mL vs 5.1±0.3 mL, P = 0.002) volume and slightly slower emptying (24.9±1.7 min vs 20.1±0.7 min, P = 0.04) of the gallbladder, together with longer OCTT (132.2±7.8 min vs 99.7±2.3 min, P = 0.00003) than controls. No differences in gastric emptying and bowel habits were found. Also, patients had higher dyspepsia (score: 6.7±1.2 vs 4.9±0.2, P = 0.027), greater appetite (P = 0.000004) and lower health perception (P = 0.00002) than controls. Autonomic dysfunction was diagnosed in 52% of patients (positive tests: 76.2% and 66.7% for parasympathetic and sympathetic involvement, respectively). Patients developing sludge during follow-up (38%, 2 with prior stones) had increased fasting and residual gallbladder volume. Conclusion: Adult β-thalassemia major patients have gallbladder dysmotility associated with delayed small intestinal transit and autonomic dysfunction. These abnormalities apparently contribute together with haemolytic hyperbilirubinemia to the pathogenesis of pigment gallstones/ sludge in β-thalassemia major.

AB - Aim: Gallbladder and gastrointestinal motility defects exist in gallstones patients and to a lesser extent in pigment gallstone patients. To investigated the role of gallbladder and gastrointestinal motility disorders in pigment gallstone formation in β-thalassemia major. Methods: Twenty-three patients with β-thalassemia major (16 females; age range 18-37 years) and 70 controls (47 females, age range 18-40 years) were studied for gallbladder and gastric emptying (functional ultrasonography), orocecal transit (OCTT, H2-breath test), autonomic dysfunction (sweat-spot, cardiorespiratory reflex tests), bowel habits, gastrointestinal symptoms and quality of life (all with questionnaires). Gallbladder content (ultrasonography) was examined before and during 8-12 mo follow-up. Results: Gallstones and/or biliary sludge were found in 13 (56%) patients. β-thalassemia major patients had increased fasting (38.0±4.8 mL vs 20.3±0.7 mL, P = 0.0001) and residual (7.9±1.3 mL vs 5.1±0.3 mL, P = 0.002) volume and slightly slower emptying (24.9±1.7 min vs 20.1±0.7 min, P = 0.04) of the gallbladder, together with longer OCTT (132.2±7.8 min vs 99.7±2.3 min, P = 0.00003) than controls. No differences in gastric emptying and bowel habits were found. Also, patients had higher dyspepsia (score: 6.7±1.2 vs 4.9±0.2, P = 0.027), greater appetite (P = 0.000004) and lower health perception (P = 0.00002) than controls. Autonomic dysfunction was diagnosed in 52% of patients (positive tests: 76.2% and 66.7% for parasympathetic and sympathetic involvement, respectively). Patients developing sludge during follow-up (38%, 2 with prior stones) had increased fasting and residual gallbladder volume. Conclusion: Adult β-thalassemia major patients have gallbladder dysmotility associated with delayed small intestinal transit and autonomic dysfunction. These abnormalities apparently contribute together with haemolytic hyperbilirubinemia to the pathogenesis of pigment gallstones/ sludge in β-thalassemia major.

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