Review article: epidemiology of gall-bladder disease - role of intestinal transit
Autor: | K. W. Heaton |
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Rok vydání: | 2000 |
Předmět: |
medicine.medical_specialty
Hepatology Bile acid Cholesterol business.industry medicine.drug_class Gallbladder Deoxycholic acid Gastroenterology Gallstones medicine.disease Review article chemistry.chemical_compound medicine.anatomical_structure chemistry Internal medicine medicine Hyperinsulinemia Pharmacology (medical) Risk factor business |
Zdroj: | Alimentary Pharmacology & Therapeutics. 14:9-13 |
ISSN: | 0269-2813 |
DOI: | 10.1046/j.1365-2036.2000.014s2009.x |
Popis: | Recent epidemiological studies have suggested that hyperinsulinaemia may be a central factor in the pathogenesis of cholesterol gallstones, explaining a probable link with physical inactivity as well as abdominal adiposity. There is also increasing evidence for the hypothesis that enrichment of bile with DCA. 'the colonic bile acid', leads to enrichment of bile with cholesterol. Biliary DCA can be raised and lowered by slowing down and speeding up colonic transit, respectively. Slow transit is characteristic of non-obese British women with gallstones and of non-obese peasants in a gallstone-prone mountain community. High biliary DCA predicts recurrence of gallstones and so does laxative usage, a pointer to constipation and therefore to slow transit. In some studies, at least, a high fibre intake is protective against gallstones. Much else besides fibre influences colonic function. Future studies of gallstone aetiology should include measurements of colonic function. Measures that speed up colonic transit should be tested for their ability to prevent gallstone formation in high-risk individuals. |
Databáze: | OpenAIRE |
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