Celiac Disease and Gallbladder: Pathophysiological Aspects and Clinical Issues
Poddighe D. Dossybayeva K. Abdukhakimova D. Akhmaltdinova L. Ibrayeva A.
October 2022MDPI
Nutrients
2022#14Issue 20
Background: Celiac Disease (CD) is an immune-mediated disorder which primarily affects the small intestine; however, extra-intestinal organs are often affected by the pathological process, too. As regards the digestive system, liver alterations in CD patients have been widely described, which can also extend to the biliary tract. Notably, gallbladder function can be altered in CD patients. In this review, we specifically analyze and summarize the main pathophysiological aspects and clinical evidence of gallbladder dysfunction in CD patients, in order to discuss the potential medical complications and clinical research gaps. In addition to some perturbations of bile composition, CD patients can develop gallbladder dysmotility, which mainly expresses with an impaired emptying during the digestive phase. The main pathophysiological determinant is a perturbation of cholecystokinin secretion by the specific duodenal enteroendocrine cells in response to the appropriate nutrient stimulation in CD patients. This situation appears to be reversible with a gluten-free diet in most cases. Despite this gallbladder impairment, CD patients do not seem to be more predisposed to gallbladder complications, such as calculous and acalculous cholecystitis. However, very few clinical studies have actively investigated these clinical aspects, which may not be completely evidenced so far; alternatively, the substantial improvements in the last two decades regarding CD diagnosis, which have reduced the diagnostic delay (and related dietary treatment), may have lessened the potential clinical consequences of CD-related gallbladder dysfunction. Specific clinical studies focused on these aspects are needed for a better understanding of the clinical implications of gallbladder alterations in CD patients.
celiac disease , cholecystitis , cholecystokinin , gallbladder , gallbladder dysmotility , gallstones , gluten-free diet
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Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan, 010000, Kazakhstan
National Research Center for Maternal and Child Health, Clinical Academic Department of Pediatrics, University Medical Center, Nur-Sultan, 010000, Kazakhstan
National Research Cardiac Surgery Center, Nur-Sultan, 010000, Kazakhstan
National Research Center for Maternal and Child Health, Program of Pediatric Gastroenterology, Clinical Academic Department of Pediatrics, University Medical Center, Nur-Sultan, 010000, Kazakhstan
Department of Medicine
National Research Center for Maternal and Child Health
National Research Cardiac Surgery Center
National Research Center for Maternal and Child Health
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