Functional CT and MR Biliary Imaging in Patients With Unexplained Abdominal Pain and Controls

Abstract

G A A b st ra ct s recruited into the European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk) with 23 658 completing 7-DFDs at enrolment. The cohort was monitored for 14 years for new symptomatic gallstones, with diagnoses confirmed by review of the clinical notes. The 7-DFDs recorded one week's diet including drink type, brands and volumes consumed. A representative sample of 3 970 and also those with gallstone disease had their 7-DFDs coded by nutritionists using a computer program containing nutrient information on 11 000 food and drink items. A cohort analysis used Cox regression modelling to estimatehazard ratios (HR) for men and women, comparing 1, 2 or 3+ cups (1 cup=250mls) of caffeinated coffee and tea intake per day versus zero intake as well as a binary variable of any caffeinated coffee vs none and decaffeinated coffee vs none. The analyses were adjusted for the risk factors: age, body mass index, energy intake, alcohol intake and physical activity in men, and also parity and hormone replacement therapy use in women. Results: 177 women (mean age of diagnosis 66.5 yrs SD=9.5 yrs) and 90 men (64.2 yrs SD=9.2 yrs) developed symptomatic gallstones. In men, caffeinated coffee intake was associated with a decreased risk of symptomatic gallstones (3+ cups day vs zero intake HR=0.48, 95% CI=0.26-0.89) with a significant trend across categories (per 1 cup increase HR=0.79, p=0.022). Drinking any caffeinated coffee compared to zero consumption in men, the HR was 0.58 (95% CI= 0.38-0.90, p=0.015). If all men consumed three or more cups of caffeinated coffee a day, then 26% of symptomatic gallstones could be prevented. No effects were found for tea and decaffeinated coffee consumption in men and any drink intake in women (any caffeinated coffee vs zero consumption HR=0.84 95% CI=0.60-1.17, p=0.30). Conclusion: The data suggests that caffeinated coffee may reduce the risk of symptomatic gallstones in men but not in women. Coffee should be measured in future studies investigating the aetiology of gallstones in men.