GALLBLADDER MOTILITY AND CHOLECYSTOKININ RELEASE DURING LONG-TERM ENTERAL NUTRITION IN PATIENTS WITH CROHNS-DISEASE

Background: Gallbladder bile stasis during long-term continuous entera l feeding may contribute to the high prevalence of gallstones in patie nts with Crohn's disease. We therefore examined the effects of continu ous enteral nutrition on gallbladder motility and cholecystokinin (CCK ) release in six patients. Methods: Gallbladder volume was measured ul trasonographically for 12 h on days 1 (start), 8, 22 (6-h interruption of enteral feeding). 36, and 43 (end) of enteral feeding. Plasma CCK was assessed at several time points. Results: Initial fasting gallblad der volume was 19.3 +/- 4.5 (mean +/- SEM) ml, which decreased to 4.9 +/- 3.6 ml after start of feeding. CCK increased from 1.5 +/- 0.3 to 3 .9 +/- 1.1 pmol/l. On days 8 and 36 the gallbladder was almost complet ely contracted, and CCK increased to 7.5 +/- 2.7 and 8.3 +/- 2.6 pmol/ 1, respectively. On days 22 and 43 gallbladder volume increased, and CCK decreased rapidly to fasting concentrations after interruption of feeding. Conclusions: During continuous enteral nutrition the gallblad der is completely contracted, and CCK concentrations remain elevated. It is therefore unlikely that long-term enteral nutrition contributes to the increased prevalence of gallstones in patients with Crohn's dis ease.