Gallbladder

Liver and Gallbladder. High dosages of oral estrogens have been reported to increase the risk for jaundice, cholestatic hepatitis, gallstones, and hepatic vein blood clots. Estrogens promote the development of hepatic neoplasms associated with increased hepatic cell regenerative activity (186,187). 

One other unique use of MTBE is a medical procedure for the removal of gallstones. This alternative to gallbladder surgery was developed at the Mayo Clinic, and takes advantage of MTBE s capabiUty to quickly dissolve cholesterol. A small incision is used to inject a small amount of MTBE direedy into the gallbladder, and the gallstone can then be removed in solution form (28). 

Because they contain both nonpolar and polar domains, these bile salt conjugates are highly effective as detergents. These substances are made in the liver, stored in the gallbladder, and secreted as needed into the intestines. 

Gallstones. Bile acids keep cholesterol soluble in gallbladder bile. Therefore, they are used for the dissolution of cholesterol gallstones. Initial treatment... 

Suppression of motor activity in general, inhibition of gallbladder contraction, gastric emptying... 

Cliolestyramine (Questran) and colestipol (Colestid) are examples of bile acid sequestrants. Bile, which is manufactured and secreted by the liver and stored in the gallbladder, emulsifies fat and lipids as these products pass through the intestine Once emulsified, fats and lipids are readily absorbed in the intestine These drug bind to bile acids to form an insoluble substance that cannot be absorbed by the intestine, so it is secreted in the feces. With increased loss of bile acids, the liver uses cholesterol to manufacture more bile This is followed by a decrease in cholesterol levels. 

Periodic laboratory tests (liver function studies) and ultrasound or radiologic examinations of the gallbladder may be scheduled by the primary health care provider. 

If diarrhea occurs, contact die primary health care provider. If symptoms of gallbladder disease (pain, nausea, or vomiting) occur, immediately contact the primary health care provider. 

Warning associated with the administration of estrogen include an increased risk of endometrial cancer, gallbladder disease, hypertension, hepatic adenoma (a benign tumor of the liver), cardiovascular disease, increased risk of thromboembolic disease and hypercalcemia in those with breast cancer and bone metastases. 

The estrogens are used cautiously in patients with gallbladder disease, hypercalcemia (may lead to severe hypercalcemia in patients with breast cancer and bone metastasis), cardiovascular disease, and liver impairment. 

Dietary fats, libers, and other carotenoids have been reported to interfere with carotenoid bioaccessibility. It is clear that by their presence in the gut, lipids create an environment in favor of hydrophobic compounds such as carotenoids. When arriving in the small intestinal lumen, dietary fats stimulate bile flow from the gallbladder and therefore enhance the micelle formation, which in turn could facilitate the emulsification of carotenoids into lipid micelles. Without micelle formation, carotenoids are poorly absorbed a minimum of 3 g of fat in meal is necessary for an efficient absorption of carotenoids, except for lutein esters that require higher amounts of fat. ... 

ACHES—for women taking hormonal contraceptives A = Abdominal pain. This may be an early warning sign of the presence of an abdominal thromboembolism, liver adenoma, or gallbladder disease. 

Venous thromboembolism Breast cancer Gallbladder disease Progestins... 

CHD is the leading cause of death among women in the United States. Retrospective data indicated that HRT was associated with a decrease in risk of CHD by 30% to 50%.21 However, the results of recent RCTs demonstrate that HRT does not prevent or treat CHD in women and that it actually may cause an increase in CHD events. The HERS, published in 1998, was the first RCT conducted in women with established CHD. This trial demonstrated an increased incidence of CHD events within the first year of treatment with HRT and an increased risk of venous thromboembolism (VTE) and gallbladder disease. There was a trend of decreasing incidence... 

In patients with normal gallbladder function, effective agents for eradication of chronic carriage include amoxicillin (3 g divided three times a day in adults for 3 months), trimethoprim-sulfamethoxazole (one double-strength tablet twice a day for 3 months), and ciprofloxacin (750 mg twice daily for 4 weeks). In patients with anatomic abnormalities, such as biliary or kidney stones, surgery combined with antibiotic therapy is indicated. 

There are two stages in the life cycle of G. lamblia the trophozoite and the cyst. G. lamblia is found in the small intestine, the gallbladder, and in biliary drainage. The distribution of giardiasis is worldwide with children being more susceptible than adults. 

Mitomycin C is an alkylating agent that forms cross-links with DNA to inhibit DNA and RNA synthesis. The pharmacokinetics of mitomycin C are best described by a two-compartment model, with an a half-life of 8 minutes and a terminal half-life of 48 minutes.31 Liver metabolism is the primary route of elimination. Mitomycin C has shown clinical activity in the treatment of anal, bladder, cervix, gallbladder, esophageal, and stomach cancer. Side effects consist of myelosuppression and mucositis, and it is a vesicant. 

Cholelithiasis can develop as a result of decreased gallbladder contractility, especially in the absence of enteral or oral intake. Lack of intestinal stimulation reduces secretion of cholecys-tokinin, a peptide hormone secreted in the duodenum that induces gallbladder contractility. The best prevention of cholelithiasis is early initiation of enteral or oral feeding, as stated earlier (to stimulate secretion of cholecystokinin, gallbladder contraction and emptying, and intestinal motility). 

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