Einfluss von Ursodeoxycholsäure auf den gastrointestinalen Lebensqualitätsindex (GLQI) bei Patienten mit "asymptomatischer" Cholezystolithiasis

Introduction: Ursodeoxycholic acid (UDCA) therapy attenuates the
risk of biliary pain and complications in patients with symptomatic
gallstones [1]. However, it is unknown whether UDCA therapy might
improve also the gastrointestinal quality of life in patients with
“asymptomatic” cholecystolithiasis. Methods: Therefore we studied
the effect of UDCA treatment in 35 patients [ = 21; age 36 – 72,
av. 56.6; = 14; age 29 – 78, av. 59,8 ] with “asymptomatic”
gall-stones, using the „Gastrointestinal Quality of Life Index“
(GIQLI) as previously introduced by Eypasch et al. [2] The 36
questions of the GIQLI had to be answered on a 5-digit scale
(0;1;2;3;4), so if added up a total score of 144 could be obtained.
The questionnaire was answered before and after a four-week
treatment with 250 mg UDCA per day, taken in the evening. Results:
The patients scored 107.0 ± 15.9 (mean ± SD ) points from an
attainable maximum of 136* prior UDCA treatment, which increased
significantly ( p < 0,01 ) to 119.0 ± 12.5 points after UDCA
application. Five patients already had a high GIQLI-score ( 120)
before the treatment with UDCA, which is indicating, that the
innocent gall-stone is not a myth. The change of the GIQLI-score
between the two measurements ranged from – 6 to + 50 points. 8
patients with an initial GIQLI-score ≤ 100 gained significantly
more points ( p < 0,01 ) ( 22.5 ± 16.6 ), than the 27 patient
with an initial GIQLI-score >100 ( 8.67 ± 6.84 ). Conclusions:
Our study shows that a “silent gall-stone” is not always as silent
as expected, and that furthermore a treatment with low dose UDCA
can improve the gastrointestinal quality of life in patients with
“asymptomatic” cholecystolithiasis, particularly in patients with
an initial GIQLI-score ≤ 100 points. References: [1] Tomida S. et
al. Hepatology 1999; 30: 6-13 [2] British Journal of Surgery 1995;
82: 216-222