Effects of physical activity on the gallbladder and biliary tract in health and disease
Roy J. Shephard in Physical Activity and the Abdominal Viscera, 2017
This chapter looks at the impact of acute and chronic physical activity upon biliary function in both health and disease. Although physical activity modifies the secretions and emptying of the healthy gall bladder, the responses to exercise have greater significance for the prevention of disease than for the enhancement of human performance. The potential benefits of physical activity as a means of augmenting emptying of the gallbladder, reducing stasis and protecting against biliary disease have as yet received surprisingly little attention. Nevertheless, a survey of the published literature found 11 reviews that concluded with varying enthusiasm that regular physical activity was helpful in preventing gallbladder disease. Gallstone formation, cholecystitis and cholecystectomy are closely intertwined problems, and many reports have examined the influence of regular physical activity upon all three conditions. Many cross-sectional studies have examined associations between habitual physical activity and some measure of gallbladder disease.
Jaundice and Liver Disease in Pregnancy
Tony Hollingworth in Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Liver diseases in pregnancy include: those present at conception; those that occur coincidentally; and those that occur as a result of pregnancy. If liver disease is suspected, the most important factor is to determine the gestational age of the pregnancy, as the differential diagnoses change with the stage of the pregnancy. A history of intravenous drug use or alcohol abuse will make certain forms of liver disease much more likely. Abdominal pain, particularly in late pregnancy, may be extremely important as it can be a sign of acute fatty liver, hepatic rupture, or eclampsia, or rather less worrying but more common, gallstones. Jaundice is rare during pregnancy, and has no prognostic importance in terms of the severity of the liver disease. In liver failure, a change in the international normalised ratio or prothrombin time is the most sensitive and rapid indicator of liver synthetic function, and hence liver failure.
Mechanisms of Pain
Benjamin Apichai in Chinese Medicine for Lower Body Pain, 2021
Nociceptive pain is caused by damage to body tissues. The noxious stimuli that cause tissue damage activate the nociceptors, which are the pain receptors located on the surface of the body or in the musculoskeletal tissues. Somatic nociceptive pain originates from the nociceptors located on the surface of the body or in the musculoskeletal tissues. A-fibers are thinly myelinated and associated with fast conduction and response, such as first acute pain and heat. C-fibers are unmyelinated and associated with longer-lasting and dull pain such as reactions to chemicals and thermal and mechanical stimuli. Neuropathic pain is caused by injury to the nerves that send the wrong pain signals to the brain. Visceral pain originates from pain receptors located in the internal organs. This type of pain is usually described as cramping, deep, aching, squeezing, constant, and pressure-like, but it is localized because it may refer, as with appendicitis or gallstones.
Cholesterolosis as a cause of acute pancreatitis
Published in Baylor University Medical Center Proceedings, 2018
Ricardo E. De Armas, Jacob M. Rosenberg, Andrew Z. Fenves
Acute pancreatitis is an inflammatory condition of the pancreas manifesting with abdominal pain and elevated serum levels of pancreatic enzymes. Gallstones and chronic alcohol use are the most commonly described causes. A less studied cause is cholesterolosis, gallbladder polyps that cause mechanical obstruction of the sphincter of Oddi. Here, we present the case of a 55-year-old woman who presented with acute pancreatitis and was found to have cholesterol polyps in her gallbladder with no evidence of gallstones. The patient underwent cholecystectomy with complete resolution of her symptoms.
Gallstones were associated with the gastrointestinal adverse events of cinacalcet in hemodialysis patients with secondary hyperparathyroidism
Published in Renal Failure, 2018
Keiichi Otsuka, Yoichi Ohno, Joji Oshima
This study aimed to investigate the association of gastrointestinal (GI) adverse events of cinacalcet with gallstones in the hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT). A total of 23 HD patients under the treatment with cinacalcet and 101 control patients were enrolled in this cross-sectional study. We investigated the prevalence of gallstones and the association of GI adverse events of cinacalcet with gallstones. The prevalence of gallstones was significantly higher in the HD patients with cinacalcet compared with the controls (47.8% vs. 15.8%). The longer time on HD, hypercalcemia, hyperphosphatemia and elevated parathyroid hormone level were observed in the HD patients with cinacalcet. Besides, GI adverse events of cinacalcet were observed more frequently in the HD patients with gallstones compared with those without gallstones (odds ratio 13.5, 95% CI: 1.80–101). Therefore, screening for gallstones before dosing cinacalcet may reduce the risk of GI adverse events in SHPT patients.
Abnormalities of lipid metabolism, gallstone disease and gallbladder function
Published in Clinical Lipidology, 2011
Silvana Zanlungo, Attilio Rigotti, Juan Francisco Miquel, Flavio Nervi
Gallstone disease is highly prevalent with a complex and multifactorial pathogenesis. Gallstones are closely related to the metabolic syndrome – associated disease conditions in which abnormal regulation of lipid metabolism secondary to insulin resistance plays a major pathogenic role. Insulin resistance increases biliary cholesterol secretion and affects gallbladder (GB) motility. Regulation of lipid metabolism and energy homeostasis is complex and the GB has been considered to have a minor regulatory role in both the intestinal absorption of lipids and metabolic homeostasis of the whole body. In fact, ablation of the GB does not affect nutrient absorption or the ability to lead a normal life. GB function regulates the cycling of bile salts through the enterohepatic circulation. Bile salts have important signaling effects that canaffect whole body metabolic homeostasis. The GB and intestinal mucosa are rich in the hormone FGF15/19 and the receptor TGR5, which participate in metabolic regulation. Recent evidence supports the hypothesis that cholecystectomy may not be innocuous and that the GB has a significant role in the regulation of hepatic triglyceride metabolism. This article provides information regarding recent advances in the understanding of the interaction between regulation of lipid metabolism, insulin resistance, gallstone disease and GB function.
Related Knowledge Centers
- Biliary Tract
- Bile
- Gallbladder
- Choledocholithiasis
- Calculi
- Cholecystolithiasis
- Enterolith