Increased risk of asymptomatic gallstones in patients with ulcerative colitis

Prevalence of Gallstones in Ulcerative Colitis and Crohn’s Disease: A Systematic Review and Meta-Analysis

The meta-analysis aimed to investigate the prevalence of gallstones (GS) in Inflammatory bowel disease (IBD), especially ulcerative colitis (UC). A systematic and thorough search was conducted on online electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from the databases' inception to April 30th, 2022. Review Manager 5.4.1 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen) was used for all statistical analyses and forest plots. Only studies that met inclusion criteria were selected. The selected studies were pooled using a random-effect model and the results were reported in the odds ratio (OR) with their corresponding 95% confidence interval (CI). Ten studies met the final inclusion criteria and were analyzed. Patients with UC had significantly higher prevalence of GS than those in the control group (OR=1.67 [1.32-2.11]; p < 0.0001; I²=58%). There was also significant prevalence of GS in Crohn’s disease (CD) than those in control group (OR=2.22 [1.82, 2.69]; p < 0.00001; I²=31%). Analysis also showed the prevalence of GS in studies conducted in Asia (OR=2.00 [1.48, 2.70]; p < 0.00001; I²=80%) and Europe (OR= 1.84 [1.32, 2.55]; p = 0.0003; I²=45%) compared to the control group. This study provided a conclusive answer to whether GS is significant in UC or not. Our meta-analysis provides a well-powered estimate that there is a prevalence of GS in UC. CD is also significantly associated with GS.

Association between Inflammatory Bowel Disease and Cholelithiasis: A Nationwide Population-Based Cohort Study

We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn’s disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the study cohort. A total of 8186 patients without IBD were selected by frequency-matching according to age, sex, comorbidities, and the index date of diagnosis, and they were identified as the control cohort. To measure the incidence of cholelithiasis, all patients were followed up until the end of 2011. The risk of developing cholelithiasis, either gallbladder stone disease (GSD; adjusted hazard ratio (aHR) = 1.76, 95% CI = 1.34–2.61) or common bile duct (CBD) stones and intrahepatic stones (IHSs; aHR = 2.78, 95% CI = 1.18–6.51), was higher for the CD cohort than for the non-IBD cohort after adjusting for age, sex, and comorbidities of hyperlipidemia, diabetes, liver cirrhosis, hypertension, chronic obstructive pulmonary disease, stroke, coronary artery disease, and hepatitis C virus infection. However, UC was related to the development of GSD (aHR = 1.44, 95% CI = 1.19–1.75) but not to CBD stones and IHSs (aHR = 1.70, 95% CI = 0.99–2.91). Our population-based cohort study demonstrated that CD is related to the development of cholelithiasis, including GSD alone and non-GSD-associated cholelithiasis. However, UC is only related to the development of GSD alone.

Risk factors for gallstones and kidney stones in a cohort of patients with inflammatory bowel diseases

Background

Gallstones and kidney stones are known complications of inflammatory bowel diseases (IBD). Risk factors have been insufficiently studied and explanatory studies date back up to 30 years. It remains unclear, whether improved treatment options also influenced risk factors for these complications.

Objectives

Identifying risk factors for gallstones and kidney stones in IBD patients.

Methods

Using data from the Swiss Inflammatory Bowel Disease Cohort Study we assessed associations of diseases characteristics with gallstones and kidney stones in univariate and multivariate logistic regression analyses.

Results

Out of 2323 IBD patients, 104 (7.8%) Crohn’s disease (CD) and 38 (3.8%) ulcerative colitis (UC) patients were diagnosed with gallstones. Significant risk factors for gallstones were diagnosis of CD, age at diagnosis, disease activity and duration, NSAID intake, extra-intestinal manifestations and intestinal surgery. Kidney stones were described in 61 (4.6%) CD and 30 (3.0%) UC patients. Male gender, disease activity, intestinal surgery, NSAID usage and reduced physical activity were significant risk factors. Hospitalization was associated with gallstones and kidney stones. The presence of gallstones increased the risk for kidney stones (OR 4.87, p<0.001).

Conclusion

The diagnosis of CD, intestinal surgery, prolonged NSAID use, disease activity and duration and bowel stenosis were significantly associated with cholecystonephrolithiasis in IBD.

Gallstone prevalence and risk factors in patients with ulcerative colitis in Korean population

This study aims to evaluate the prevalence, risk factors, and relative risk of gallstones and associated disease in patients with ulcerative colitis (UC). Medical records of 311 patients diagnosed with UC between January 2004 and February 2015 were reviewed retrospectively. To assess relative risk, 622 patients matched by age, sex, and body mass index were included as a control group. Gallstones were detected in 8% (25/311) of UC patients and in 3.9% (24/622) of the control group. Prevalence was significantly higher in the UC group (odds ratio [OR], 2.178; P = .007). Mean age of gallstone patients was 57.1 ± 17.8 years in the UC group, and mean disease duration of UC was 67.2 ± 38.8 months. The male-to-female ratio of gallstone patients in the UC group was 2.13:1. Mean interval from diagnosis of UC to detection of gallstones was 17.8 ± 30 months. Six UC patients with gallstones underwent cholecystectomy or endoscopic retrograde cholangiography for symptomatic disease and complications. In univariate analysis, diabetes, hypertension, age ≥65 years, and history of more than 3 admissions were significantly associated with gallstone in UC patients. In multivariate analysis, age ≥65 years (OR, 2.655; P = .033) and hospitalization ≥3 times (OR, 4.1; P = .001) were statistically significant risk factors for gallstones in UC patients. This study shows that UC patients have a significantly higher risk of gallstones compared to the general population (OR, 2.178; P = .007), especially those who are older, with a history of multiple admissions.