Gallstone Disease Raises Risk of Inflammatory Bowel Disease, Study Finds

Findings from the studies published in the American Journal of Gastroenterology revealed that individuals with gallstones have a higher likelihood of developing IBD, independent of traditional risk factors.

The analysis revealed that individuals with gallstone disease have a 38% higher risk of developing IBD (HR 1.38). Specifically, the risk for Crohn's disease increased by 68% (HR 1.68), while the risk for ulcerative colitis rose by 24% (HR 1.24).

"Supporting these findings, an additional study found that the risk for IBD was three times greater in those with gallstones, with Crohn's disease risk increasing more than fivefold. Notably, these risks remained consistent even after the removal of gallstones," the researchers reported.

Gallstone disease, a condition characterized by the formation of stones in the gallbladder, is often associated with dietary factors, obesity, and other metabolic disorders. Gallstone disease affects intestinal inflammation, bile flow, and gut microbiota, potentially raising the risk of inflammatory bowel disease. However, there has been a limited number of epidemiological studies examining the links between gallstone disease and subsequent IBD risk.

To fill this knowledge gap, Wenbo Meng, Department of General Surgery, The First Hospital of Lanzhou University. Lanzhou, Gansu, China, and colleagues aimed to investigate the association between gallstone disease and the subsequent risk of developing IBD, including its subtypes while accounting for traditional risk factors and exploring potential underlying mechanisms.

For this purpose, the researchers conducted a combined analysis of three prospective cohort studies: the Nurses’ Health Study (NHS), NHS II, and the UK Biobank, which was further replicated in a case-control study known as the Chinese IBD Etiology Study (CIES). They evaluated the hazard ratios (HRs) and odds ratios (ORs) relating gallstone disease to IBD risk using Cox regression and conditional logistic regression, adjusting for demographic characteristics, lifestyle factors, comorbidities, and medication usage.

Based on the study, the researchers revealed the following findings:

• The researchers identified 3,480 cases of inflammatory bowel disease over 2,127,471 person-years of follow-up in the three cohort studies.
• Participants with gallstone disease faced a 38% increased risk of IBD (HR 1.38), a 68% increased risk for Crohn’s disease (HR 1.68), and a 24% increased risk for ulcerative colitis (HR 1.24).
• In the Chinese IBD Etiology Study (CIES), even stronger associations were observed, IBD showed an odds ratio (OR) of 3.03, Crohn’s disease an OR of 5.31, and ulcerative colitis an OR of 1.49.
• There were no significant differences in the estimated associations between the presence of unremoved gallstones and previous cholecystectomy regarding IBD risk.

The findings revealed that gallstone disease was associated with a heightened risk of inflammatory bowel disease and its subtypes, regardless of traditional risk factors.

"Additional research is necessary to validate these associations and to better understand the underlying biological mechanisms involved," the researchers concluded.

Reference:

Mi, Ningning1,2,3,†; Yang, Man4,5,†; Wei, Lina6; Nie, Peng7; Zhan, Shukai8; Nguyen, Long H9,10; Smith, Fang Gao11,12; Acharjee, Animesh13,14; Liu, Xudong15; Huang, Junjie16; Xia, Bin3,4,5,*; Yuan, Jinqiu3,4,5,*; Meng, Wenbo1,2,*. Gallstone disease is associated with an increased risk of inflammatory bowel disease: results from three prospective cohort studies. The American Journal of Gastroenterology ():10.14309/ajg.0000000000003111, October 04, 2024. | DOI: 10.14309/ajg.0000000000003111