The prevalence of gallstone disease in a defined cohort of patients with Crohn's disease

OBJECTIVE: Crohn's disease (CD) is associated with a high prevalence of gal lstone disease but the relative risk has not been completely established. I leal disease or resection have been considered as contributing factors to t he increased risk. The aim of this study was to evaluate the prevalence of gallstone disease in a defined cohort of CD patients, to evaluate possible risk factors, and to evaluate the relative risk compared with the general p opulation. METHODS: All inhabitants in Stockholm County born in 1933-1935 or 1953-1955 , with CD diagnosed between 1955-1989 and not having had a previous cholecy stectomy, were invited for an ultrasonography of the gallbladder. The preva lence of gallstone disease was related to disease extent, previous intestin al resections, age, and gender. The relative risk of developing gallstones was calculated using a recent study of gallstone disease in general, with s imilar age groups as controls. RESULTS: We found that 26.4% had gallstone disease (relative risk [RR] = 1. 8; 95% confidence interval [CI], 1.2-2.7). The number of previous intestina l resections was the only significant risk factor. There was no significant difference in gallstone disease between gender (28.2% vs 24.1%) or age (34 % vs 21.8%). CONCLUSIONS: Patients with Crohn's disease, regardless of gender and age, h ave almost a doubled risk of developing gallstone disease compared with the general population. Circumstances related to laparotomy may contribute to the increased risk. The lack of association between the disease extent and the site of previous intestinal resection, together with a previous finding of normal cholesterol saturation of the bile in patients with CD, indicate that these patients may develop pigment stones rather than cholesterol sto nes. (C) 1999 by Am. Cell. of Gastroenterology.