Gallbladder function

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. 

Cholekinetics stimulate the gallbladder to contract and empty, e.g., egg yolk the osmotic laxative MgS04, the cholecystokinin-related ceniletide (given parenterally). Cholekinetics are employed to test gallbladder function for diagnostic purposes. 

Kern F Jr, Everson GT, DeMark B, McKinley C, Showalter R, Braverman DZ, Szczepanik-Van Leeuwen P, Klein PD. Biliary lipids, bile acids, and gallbladder function in the human female effects of contraceptive steroids. J Lab Clin Med 1982 99(6) 798-805. 

Rhodes M, James RA, Bird M, Clayton B, Kendall-Taylor P, Lennard TW. Gallbladder function in acromegalic patients taking long-term octreotide evidence of rebound hypermotility on cessation of treatment. Scand J Gastroenterol 1992 27(2) 115—8. 

Gallbladder bile Glycine and taurine conjugates ofC, CDC. DC 150-350 mmol/liter Concentration dependent on gallbladder function C7... 

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

Table 8.2 summarises some of the conditions in which there is impaired gallbladder motor function and an associated increase in the prevalence of either sludge (which may pre-dispose to stone formation), frank gallstones or both. The role of Octreotide (OT) will now be focused upon since this illustrates the whole sequence of pathogenic changes found in conventional GBS disease -albeit eclipsed into weeks or months. 

Table 8.2 Clinical conditions in which gallbladder motor function is impaired.

Flepatic or severe renal dysfunction, including primary biliary cirrhosis, and patients with unexplained persistent liver function abnormality preexisting gallbladder disease hypersensitivity to fenofibrate. 

Transient abnormalities in liver function tests (eg, elevation in serum bilirubin, alkaline phosphatase, serum transaminases), and reduced biliary excretion of contrast media used for visualization of the gallbladder have also been observed. Drug/Food interactions Food interferes with the absorption of rifampin, possibly resulting in decreased peak plasma concentrations. Take on an empty stomach with a full glass of water. 

Although histamine is distributed in the gallbladder, its functional effects have been identified only following activation of Hi and H2 receptors which mediate muscle contraction and relaxation, respectively (Impicciatore 1978) The H3 receptor agonist (R)a-... 

CCK-PZ 50 113-116), whose C-terminal pentapeptide sequence is identical with that of gastrin, is discharged into the blood from certain intestinal cells and reaches the gallbladder, where it causes the bile to discharge into the intestine, thus promoting digestion. Cholecystokinin also functions as a cerebral neurotransmitter. 

Bile is produced by hepatocytes from several essential components, including water, bile acids, cholesterol, phospholipids and bilirubin. Most of these substances are absorbed in the distal ileum and delivered to the hepatocyte via the portal vein. The liver excretes approximately 500-600 mL of bile each day, most of which is stored in the gallbladder. Bile acids have an important function in emulsifying lipids in the digestive tract, which improves digestion by pancreatic lipases. 

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