The effect of Helicobacter pylori infection on gallbladder motility and plasma cholecystokinin levels in patients with functional dyspepsia

Yıl 2010, Cilt: 9 Sayı: 3, 110 - 116, 01.12.2010

Ferda Akbay Harmandar Hasan Ümit Gülbin Ünsal Hakan Erbaş

Öz

Background and Aim: It is known that Helicobacter pylori infection affects gastrointestinal motility, pancreatic secretion and gastrointestinal hormones, and some authors have considered that the infection can also affect gallbladder motility. This study was undertaken to evaluate whether Helicobacter pylori has any effect on gallbladder motility in patients with functional dyspepsia. Material and Methods: Fifty patients with functional dyspepsia were studied, and 31 of them were Helicobacter pylori (+) and 19 were Helicobacter pylori (-).Helicobacter pylori was searched by histopathological method and rapid urease test. We separated the subjects as Helicobacter pylori (+) and (-) according to the histopathological method. In both groups, gallbladder volumes were measured by ultrasonographic method in fasting state and at postprandial 30, 60, 90 and 120 minutes, and ejection fraction values were calculated. All patients' fasting plasma cholecystokinin levels were determined by ELISA method. Results: Fasting volume and V60 were found significantly high in the Helicobacter pylori (+) group, while V30, 90, 120 were similar in both groups. Plasma cholecystokinin levels were found significantly low in the Helicobacter pylori (+) groups. Conclusion: These results suggest that Helicobacter pylori infection can play a role in gallstone formation and biliary dyskinesia by damaging gallbladder motility; therefore, more studies are needed to clarify this subject.

Anahtar Kelimeler

Helicobacter pylori, gallbladder motility, cholecystokinin, functional dyspepsia

Fonksiyonel dispepsili hastalarda Helikobakter pilori infeksiyonunun safra kesesi motilitesi ve plazma kolesistokinin düzeyleri üzerine etkisi

Öz

Giriş ve Amaç: Helikobakter pilori infeksiyonunun gastrointestinal motilite, pankreatik sekresyon ve gastrointestinal hormon salınımı üzerine etkileri olduğu bilinmekte olup, safra kesesi motilitesini de etkileyebileceği düşüncesi söz konusudur. Bu çalışmanın amacı da fonksiyonel dispepsili hastalarda Helikobakter pilori varlığının kese motilitesi üzerine etkisini araştırmaktadır. Gereç ve Yöntemler: Helikobakter pilori (+) 31 ve Helikobakter pilori (-) 19 olmak üzere toplam 50 fonksiyonel dispepsili olgu çalışmaya alındı. Helikobakter pilori varlığına histopatolojik yöntem ve üreaz testi ile bakıldı. Histopatolojik yöntem esas alınarak olgular (+) ve (-) olmak üzere iki gruba ayrıldı. Açlık ve postprandiyal 30, 60, 90, 120. dakikalarda kese volümleri ultrasonografi ile ölçüldü ve açlık plazma kolesistokinin seviyelerine bakıldı. Bulgular: Açlık kese hacimleri ve postprandiyal 60. dakikada ölçülen kese hacmi Helikobakter pilori (+) olan grupta daha yüksek olarak bulundu. Postprandiyal 30, 90, 120. dakikalarda ölçülen kese hacimleri her iki grupta benzerdi. Plazma kolesistokinin seviyeleri Helikobakter pilori (+) olan grupta düşük olarak bulundu. Sonuç: Bu bulgular Helikobakter pilori infeksiyonunun safra kesesi motilitesini bozarak, biliyer diskinezi ve taş oluşumunda rol oynayabileceğini düşündürmekle beraber, bu konuda yapılacak daha fazla çalışmaya ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Helicobacter pylori, safra kesesi motilitesi, kolesistokinin, fonksiyonel dispepsi

Kaynakça

• 1- McColl K, Murray L, El-Omar E, et al. Symptomatic benefit from eradicating
• Helicobacter pylori infection in patients with nonulcer
• dyspepsia. N Engl J Med 1998; 339: 1869-74.
• Moayyedi P, Soo S, Deeks J, et al. Eradication of Helicobacter pylo- ri for non-ulcer dyspepsia. Cochrane Database Syst Rev 2005; 1: CD002096.
• Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med 2002; 347: 1175-86.
• Malaty HM. Epidemiology of Helicobacter pylori infection. Best Pract Res Clin Gastroenterol 2007; 21: 205-14.
• Franceschi F, Gasbarrini A. Helicobacter pylori and extragastric di- seases. Best Pract Res Clin Gastroenterol 2007; 21: 325-34.
• Mihaljevic S, Karner I, Dmitrovic B, et al. Hormonal regulation of
• gastric secretion and (Suppl 1): 13-6.
• Chiloiro M, Russo F, Riezzo G, et al. Effect of Helicobacter pylori in- fection on gastric emptying and gastrointestinal hormones in dyspeptic and healthy subjects. Dig Dis Sci 2001; 46: 46-53.
• Bulajic M, Stimec B, Milicevic M, et al. Modalities of testing Helico- bacter pylori in patients with nonmalignant bile duct diseases. World J Gastroenterol 2002; 8: 301-4.
• McColl Kel, El-Omar E, Gillen D. Helicobacter pylori gastritis and gastric physiology. Gastroenterol Clin North Am 2000;29:687-703, viii.
• Onbaşı KT, Şahin HA, Şahin İ, et al. Helicobacter pylori. Sendrom 2001; 13: 73-8.
• O’Morain C. Role of Helicobacter pylori in functional dyspepsia. World J Gastroenterol 2006; 12: 2677-80.
• Tucci A, Corinaldesi R, Stanghelli V, et al. Helicobacter pylori infec- tion and gastric function in patients with chronic idiopathic dyspepsia. Gastroenterology 1992; 103: 768-74.
• Chua ASB, Keeling PW. Cholecystokinin hyperresponsiveness in functional dyspepsia. World J Gastroenterol 2006; 12: 2688-93.
• Jonsson BH, Uvnas-Moberg K, Theorell T, Gotthard R. Gastrin, cho- lecystokinin and somatostatin in a laboratory experiment of pati- ents with functional diyspepsia. Psychosom Med 1998; 60: 331-7.
• Dominguez-Munoz JE, Malfertheiner P. Effect of Helicobacter pylo- ri infection on gastrointestinal motility, pancreatic secretion and hormone release in asymptomatic humans. Scand J Gastroenterol 2001; 36: 1141-7.
• Porstmann T, Kiessig ST. Enzyme immunoassay techniques. An overview. J Immunol Methods 1992; 150: 5-21.
• Jazrawi RP. Measurement of gallbladder motor functions. An over- view. Dig Liver Dis 2003; 35 (Suppl 3): S51-5.
• Dodds WJ, Groh WJ, Darweesh RM, et al. Sonographic measure- ment of gallbladder volume. AJR Am J Roentgenol 1985; 145: 1009-11.
• Prandini N. Methods of measuring gallbladder motor functions-the need for standardization: scintigraphy. Dig Liver Dis 2003; 35 (Suppl 3): 62-6.
• Fraquelli M, Pagliarulo M, Colucci A, Paggi S, Conte D. Gallbladder motility in obesity, diabetes mellitus and coeliac disease. Dig Liver Dis 2003; 35 (Suppl 3): 12-6.
• Budzynski A, Bobrzynski A, Lorens K, et al. The Influence of cho- lecystokinin on gastric myoelectrical activity ın duodenal ulcer fol- lowing helicobacter pylori eradication. J Physiol Pharmacol 2002; 53: 171-82.
• Abaylı B, Colakoğlu S, Serin M, et al. Helicobacter pylori in the etio- logy of cholesterol gallstones. J Clin Gastroenterol 2005; 39: 134- 7.
• Pauletzki J, Cicala M, Spengler U. Gallbladder emptying during high-dose cholecystokinin infusions. Effect in patients with gallsto- ne disease and healthy controls. Scand J Gastroenterol 1995; 30: 128-32.
• Pauletzki J, Cicala M, Holl J, et al. Correlation between gallbladder fasting volume and postprandial emptying in patients with gall sto- nes and healthy controls. Gut 1993; 34: 1443-7.
• Zhu J, Han TQ, Chen S, et al. Gallbladder motor function, plasma cholecystokinin and cholecystokinin receptor of gallbladder in cho- lesterol stone patients. World J Gastroenterol 2005; 11: 1685-9.
• Portincasa P, Moschetta A, Colecchia A, Festi D, Palasciano G. Me- asurements of gallbladder motor function by ultrasonography:to- wards standardization. Dig Liver Dis 2003; 35 (Suppl 3): 56-61.
• Penning C, Gielkens HA, Delemarre JB, et al. Gallbladder emptying in severe idiopathic constipation. Gut 1999; 45: 264-8.
• Hovelius B, Andersson SI, Hagander B, et al. Dyspepsia in general practice: history and symptoms in relation to Helicobacter pylori se- rum antibodies. Scand J Gastroenterol 1984; 29: 506-10.