| Gallbladder disease is a common condition
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| | have been reported in Celiac disease,
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| typically affecting young and otherwise
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| | primarily in the European literature.
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| healthy individuals. Risk factors include
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| | Colli et. al in Italy noted increased
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| obesity, diabetes, female gender,
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| | fasting volumes of the gallbladder by
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| pregnancy, family history, rapid weight
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| | ultrasound in untreated Celiac patients
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| loss, liquid protein diets, and race or
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| | and Mariciani et. al. in the U.K. found
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| ethnic background. When typical symptoms
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| | increased gallbladder volumes and
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| of right sided upper abdominal pain,
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| | elevated gallbladder ejection fractions
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| nausea, vomiting, and bloating occur
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| | using MRI. Low CCK levels have been
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| within 15-90 minutes of eating,
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| | reported in Celiac patients (Deprez
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| especially a fatty meal, gallstones are
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| | et.al. 2002, Rehfeld 2004). This
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| usually suspected. Ultrasound of the
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| | physician has had several Celiac disease
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| gallbladder is the first test ordered and
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| | patients who have had high gallbladder
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| will confirm the presence or absence of
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| | ejection fractions (typically >90%)
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| gallstones. If gallstones are confirmed
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| | associated with classic gallbladder
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| then surgical removal of the gallbladder
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| | symptoms that resolved after gallbladder
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| is recommended.However, if the ultrasound
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| | surgery. Chronic gallbladder disease was
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| is negative or normal and gallbladder
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| | confirmed pathologically.Gallbladder
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| disease is still suspected a nuclear test
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| | disease should be considered in Celiac
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| called biliary scintography or more
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| | disease patients despite normal
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| commonly called HIDA scan is ordered. The
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| | ultrasound and HIDA tests, especially if
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| basis of this test is the fact that a
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| | a "supranormal" ejection fraction is
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| radiolabeled chemical is administered
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| | noted and pain reproduced with CCK.
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| intravenously that is concentrated in the
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| | Patients with abnormal high gallbladder
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| liver where bile is made before being
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| | ejection fractions should be considered
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| stored in the gallbladder between meals.
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| | as possible undiagnosed Celiacs and
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| If the gallbladder is diseased it may
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| | should undergo blood tests for Celiac
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| fail to be seen on the scan due to
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| | disease and consideration of upper
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| blockage or fail to empty as expected
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| | endoscopy with small bowel biopsy.1.
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| when a hormone called cholecystokinin
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| | Fraquelli M; Colli A; Colucci A; Bardella
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| (CCK) is given intravenously. CCK is
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| | MT; Trovato C; Pometta R; Pagliarulo M;
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| present in the body and released with
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| | Conte D. Accuracy of ultrasonography in
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| meals to stimulate gallbladder emptying
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| | predicting celiac disease. Arch Intern
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| of bile into the intestine for digestion.
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| | Med. 2004; 164(2):169-74.2. Marciani L;
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| Typically, the gallbladder will empty a
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| | Coleman NS; Dunlop SP; Singh G; Marsden
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| third or more of its volume when CCK is
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| | CA; Holmes GK; Spiller RC; Gowland PA.
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| given during a HIDA scan but usually not
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| | Gallbladder contraction, gastric emptying
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| more than 70-80%. The fraction of volume
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| | and antral motility:single visit
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| the gallbladder empties is referred to as
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| | assessment of upper GI function in
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| the ejection fraction. A low ejection
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| | untreated celiac disease using
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| fraction is typical of a diseased
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| | echo-planar MRI. J Magn Reson Imaging.
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| gallbladder. Reproduction of the typical
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| | 2005; 22(5):634-8.3. Deprez P; Sempoux C;
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| pain of gallbladder disease and a low
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| | Van Beers BE; Jouret A; Robert A; Rahier
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| ejection fraction are considered
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| | J; Geubel A; Pauwels S; Mainguet P.
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| diagnostic of gallbladder disease in the
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| | Persistent decreased plasma
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| absence of gallstones and results in a
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| | cholecystokinin levels in celiac patients
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| recommendation that the gallbladder be
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| | under gluten free diet:respective roles
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| removed surgically.An unusual phenomenon
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| | of histological changes and nutrient
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| has been observed in some Celiac
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| | hydrolysis. Regul Pept.
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| patients. Gallbladder type abdominal pain
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| | 2002;110(1):55-634. Rehfeld JF. Clinical
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| without gallstones and a "supranormal"
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| | endocrinology and metabolism.
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| gallbladder ejection fraction. Surgery
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| | Cholecystokinin. Best Pract Res Clin
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| relieves the gallbladder type pain and a
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| | Endocrinol Metab. 2004; 18(4):569-86.Dr.
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| diseased gallbladder is found. Radiology
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| | Scot Lewey is a physician who is
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| studies have been reported in the
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| | specialty trained and board certified in
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| literature that shed light on this
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| | the field of gastroenterology (diseases
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| phenomenon though it's significance has
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| | of the digestive system) who practices
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| been largely missed by the medical
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| | his specialty in Colorado.
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| community.Various ultrasound findings
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