DO PATIENTS WITH SYSTEMIC-SCLEROSIS HAVE ABNORMAL GALLBLADDER FUNCTION

Objective: To determine gallbladder motility in patients with systemic sclerosis. Design: Case control study. Setting: University hospital, out-patient department of rheumatology. Patients: Ten patients with sy stemic sclerosis according to the criteria of the American Rheumatism Association with documented involvement of the gastrointestinal tract and 10 healthy controls marched for age, sex and body mass index. Inte rvention: Cephalic vagal cholinergic simulation by modified sham feedi ng and hormonal stimulation by infusion of cholecyslokinin. Measuremen ts: Gallbladder volume obtained by ultrasonography and determination o f plasma cholecystokinin concentrations. Results: Fasting gallbladder volumes were not significantly different between patients with systemi c sclerosis and controls (19.6 +/- 1.9 cm(3) and 23.3 +/- 2.9 cm(3), r espectively, mean plus or minus standard error of the mean). Neither w ere there significant differences in reduction of gallbladder volume i n response to modified sham feeding (35 +/- 4% and 33 +/- 4%, respecti vely) nor during cholecystokinin infusion (56 +/- 4% and 60 +/- 6%, re spectively). The increase in plasma cholecystokinin levels during infu sion was not different in the two groups. Conclusion: Gallbladder moti lity in patients with systemic sclerosis is preserved in response to b oth cholinergic and hormonal stimulation, even when other gastrointest inal motor disturbances are present. These results suggest that patien ts with systemic sclerosis are not at increased risk for choletithiasi s because of gallbladder dysmotility.