Proton pump inhibitors reduce gallbladder function
In the authors’ previous study of gallbladder function before and after fundoplication, 58% of the patients demonstrated preoperative gallbladder motor dysfunction, and 86% of those retested after operation and cessation of proton pump inhibitors (PPIs) normalized. Because no study has directly assessed the impact of antisecretory agents on gallbladder function, this study measured gallbladder ejection fraction (GBEF) in healthy volunteers before and after initiation of PPIs.
A total of 19 subjects completed the study, which included baseline determination of GBEF by cholecystokinin-stimulated hepatobiliary acid scan, 30 days of antisecretory therapy with omeprazole (40 mg daily), and repeat GBEF on day 30. Subjects were surveyed regarding compliance and symptoms.
For 15 of 19 subjects, PPI therapy was associated with reduced gallbladder motility. Evolution of symptoms consistent with a biliary etiology was reported by 26.7% of these subjects.
Short-term PPI therapy reduces gallbladder motility in healthy volunteers. Chronic PPI therapy may pose a risk for long-term gallbladder dysfunction and biliary complications.
KeywordsBiliary dyskinesia Gallbladder ejection fraction Gastrin GERD Proton pump inhibitors
- 2.Bardhan KD (1999) Pantoprazole: a new proton pump inhibitor in the management of upper gastrointestinal disease. Drugs Today (Barc) 35: 773–808Google Scholar
- 11.Gallup Organization (1988) A Gallup Organization National Survey: Heartburn Across America. Gallup Organization, Princeton, NJGoogle Scholar
- 18.Ohara T, Morishita T, Suzuki H, Masaoka T, Ishii H (2004) Usefulness of proton pump inhibitor (PPI) maintenance therapy for patients with Helicobacter pylori-negative recurrent peptic ulcer after eradication therapy for H. pylori: pathophysiological characteristics of H. pylori-negative recurrent ulcer scars and beyond acid suppression by PPI. Hepatogastroenterology 51: 338–342PubMedGoogle Scholar
- 25.Vaczek D (2003) Top 200 drugs of 2002. Pharm Times, April p 20Google Scholar
- 27.Watson S, Arkinstall S (1994) Cholecystokinin (CCK) and gastrin. In: Watson S, Arkinstall S (eds) The G Protein-Linked Receptor Factsbook. Academic Press, London pp 89–95Google Scholar