Disorders Of Gallbladder Research Articles

Causal association of polyunsaturated fatty acids with biliary tract diseases: A Mendelian randomization study

The evidence connecting polyunsaturated fatty acids (PUFAs) to biliary problems is still highly contested and speculative despite the fact that biliary diseases are common and PUFAs have long been studied for their potential health benefits. This work used Mendelian randomization (MR) techniques in conjunction with genome-wide association study (GWAS) data to clarify the causal relationships between PUFAs and biliary tract diseases. We compiled data on PUFAs, including Omega-3 fatty acids, Omega-6 fatty acids, and the ratio of Omega-6 to Omega-3 fatty acids (Omega-6:Omega-3), using GWAS. MR was used to examine biliary tract problems (cholecystitis, cholelithiasis, gallbladder cancer, primary biliary cholangitis, primary sclerosing cholangitis, and disorders of gallbladder, biliary tract and pancreas). Single nucleotide polymorphisms significantly associated with PUFAs were selected as instrumental variables to estimate causal effects on biliary tract diseases. The final results were analyzed using five MR analysis techniques. Inverse variance weighting (IVW) was used as the primary outcome. And IVW was utilized in conjunction with the other MR analysis techniques (MR-Egger, weighted median, simple mode, and weighted mode). Additionally, we evaluated heterogeneity and horizontal multiplicity using the MR-Egger intercept test and Cochrane's Q test, respectively. Finally, to increase the accuracy and precision of the study outcomes, we carried out a number of sensitivity analyses. We found that Omega-3 fatty acids reduced the risk of cholecystitis (OR: 0.851, P=0.009), cholelithiasis (OR: 0.787, P=8.76e-5), and disorders of gallbladder, biliary tract and pancreas (OR: 0.842, P=1.828e-4) but increased the primary biliary cholangitis (OR: 2.220, P=0.004). There was no significant association between Omega-3 fatty acids and risk of gallbladder cancer (OR: 3.127, P=0.530) and primary sclerosing cholangitis (OR: 0.919, P=0.294). Omega-6 fatty acids were associated with a reduced risk of cholecystitis (OR: 0.845, P=0.040). However, they were not linked to an increased or decreased risk of cholelithiasis (OR: 0.878, P=0.14), gallbladder cancer (OR: 4.670, P=0.515), primary sclerosing cholangitis (OR: 0.993, P=0.962), primary cholestatic biliary cholangitis (OR: 1.404, P=0.509), or disorders of gallbladder, biliary tract and pancreas. Omega-6:Omega-3 fatty acids were linked to a greater risk of cholecystitis, cholelithiasis, and disorders of gallbladder, biliary tract and pancreas (OR:1.168, P=0.009, OR:1.191, P=1.60e-6, and OR:1.160, P=4.11e-6, respectively). But (OR: 0.315, P=0.010) was linked to a decreased risk of primary biliary cholangitis. Not linked to risk of primary sclerosing cholangitis (OR: 1.079, P=0.078) or gallbladder cancer (OR: 0.046, P=0.402). According to the MR-Egger intercept, our MR examination did not appear to be impacted by any pleiotropy (all P>0.05). Additionally, sensitivity studies validated the accuracy of the calculated causation. Inconsistent causative relationships between PUFAs and biliary tract diseases were revealed in our investigation. However, Omega-3 fatty acids were found to causally lower the risk of cholecystitis, cholelithiasis, and disorders of gallbladder, biliary tract and pancreas. Omega-3 fatty acids increased the risk of primary biliary cholangitis in a causative way. Omega-3 fatty acids with the risk of gallbladder cancer and primary sclerosing cholangitis did not have any statistically significant relationships. Omega-6 fatty acids were not significantly causally connected with the risk of cholelithiasis, gallbladder cancer, primary sclerosing cholangitis, or disorders of gallbladder, biliary tract and pancreas. However, they did play a causative role in lowering the risk of cholecystitis. Omega-6:Omega-3 fatty acids decreased the risk of primary biliary cholangitis but increased the risk of cholecystitis, gallstone disease, and disorders of gallbladder, biliary tract and pancreas. They had no effect on the risk of gallbladder cancer or primary sclerosing cholangitis. Therefore, additional research should be done to examine the probable processes mediating the link between polyunsaturated fatty acids and the risk of biliary tract diseases.

Медикаментозная модуляция активности генерации микроРНК при функциональных расстройствах желчного пузыря и сфинктера Одди у детей

Актуальность. Проблема функциональных расстройств желчного пузыря и сфинктера Одди является очень актуальной в детской гастроэнтерологии. Цель: усовершенствование лечения функциональных расстройств желчного пузыря и сфинктера Одди у детей на основании изучения активности генерации микроРНК. Материалы и методы. Обследовано 70 детей с функциональными расстройствами желчного пузыря и сфинктера Одди. 50 пациентов получали стандартную терапию в сочетании с урсодезоксихолевой кислотой в виде препарата Укрлив® в форме суспензии, а 20 пациентов — стандартную терапию без урсодезоксихолевой кислоты. До начала лечения и после окончания терапии у всех детей проведено молекулярно-генетическое исследование с определением уровня экспрессии микроРНК-378f, микроРНК-4311, микроРНК-4714-3p в сыворотке крови методом полимеразной цепной реакции в реальном времени. Результаты. Установлено, что у детей с функциональными расстройствами желчного пузыря и сфинктера Одди после терапии урсодезоксихолевой кислотой наблюдалось достоверное снижение уровней аспартатаминотрансферазы — с 34,96 ± 1,31 н/л до 26,18 ± 0,97 н/л, щелочной фосфатазы — с 507,92 ± 19,94 н/л до 359,53 ± 16,59 н/л в сыворотке крови и повышение сократительной функции желчного пузыря с 23,44 ± 1,56 % до 45,56 ± 1,68 % (р < 0,05). Выявлено, что после проведения стандартной терапии в сочетании с урсодезоксихолевой кислотой (Укрлив® суспензия) у детей с функциональными расстройствами желчного пузыря и сфинктера Одди уровень экспрессии микроРНК-378f приблизился к 5,23 ± 0,70 УО, что статистически значимо выше, чем до терапии (р < 0,05). На фоне проводимой стандартной терапии как с добавлением урсодезоксихолевой кислоты, так и без нее профиль экспрессии микроРНК-4714-3p в сыворотке крови у обследованных детей 1-й и 2-й групп статистически значимо резко снизился до уровня 1,93 ± 0,58 УО и 1,14 ± 0,53 УО соответственно (р < 0,05). Выводы. Полученные результаты показали, что под влиянием урсодезоксихолевой кислоты у детей регрессируют клинико-параклинические проявления функциональных расстройств желчного пузыря и сфинктера Одди. Обнаружена уникальная способность урсодезоксихолевой кислоты в форме суспензии Укрлив® влиять на активность генерации микроРНК-378f и ­микроРНК-4714-3p, которые являются генными регуляторами клеточных механизмов, влияющих на экспрессию генов на посттранскрипционном уровне.

Прогнозирование холеретической терапии функциональных расстройств желчного пузыря и сфинктера Одди у детей

Актуальность.На современном этапе важное значение приобретает ранняя диагностика функциональных расстройств желчного пузыря и сфинктера Одди (ФР ЖП и СФО) у детей и своевременное назначение эффективной холеретической терапии. Цель работы: определить прогностические факторы риска развития ФР ЖП и СФО у детей и спрогнозировать эффективность холеретической терапии с добавлением препаратов урсодезоксихолевой кислоты (УДХК). Материалы и методы. Обследованы и пролечены 70 детей с ФР ЖП и СФО в возрасте от 4 до 14 лет. С помощью последовательного (секвенционного) анализа Вальда проанализированы 140 клинико-лабораторных, молекулярно-генетических и инструментально-диагностических параметров, для каждого из них рассчитан относительный риск (ОР) и диагностический коэффициент. Результаты.Факторами риска развития ФГ ЖП и СФО установлены: наличие ФР ЖП и СФО у отца и родственников по линии матери (ОР = 1,60 и ОР = 1,60 соответственно), масса тела при рождении менее 3 кг (ОР = 1,95), возникновение первого эпизода клинико-параклинических проявлений в возрасте от 2 до 6 лет (ОР = 1,47), уровни показателей биохимической гепатограмы: холестерина — 43,7–52,0 ммоль/л (ОР = 1,83), аспартатаминотрансферазы — 45,0–59,0 н/л (ОР = 3,21) и аланинаминотрансферазы — 28,3–38,0 н/л (ОР = 3,21). Определена высокая эффективность холеретической терапии с добавлением препаратов УДХК при ФР ЖП и СФО у детей (ОР = 4,13). Существенное значение приобретает использование УДХК в холеретический терапии в анамнезе заболевания (ОР = 3,67). Установлено, что после получения лечения у детей в качестве протекторного фактора определены уровни экспрессии микро-РНК-378f — 3,07–6,14 усл.ед. (ОР = 0,37), микро-РНК-4311 — 2,51–5,01 усл.ед. (ОР = 0,18), микро-РНК-4714-3р — 3,19–6,38 усл.ед. (ОР = 0,31). Разработаны математические модели, которые можно использовать для установления вероятности развития функциональных расстройств желчного пузыря и сфинктера Одди у детей и для определения эффективности их холеретической терапии. Выводы. Высокие показатели эффективности и простота в использовании математических моделей прогноза вероятности развития функциональных расстройств желчного пузыря и сфинктера Одди у детей и прогнозирования эффективности холеретический терапии с добавлением препаратов урсодезоксихолевой кислоты позволяют рекомендовать их в практической деятельности педиатра, семейного врача и детского гастроэнтеролога для своевременного назначения рациональной терапии и проверки ее эффективности.

Хронічний панкреатит: про загальні положення щодо лікування

В огляді літератури обговорюються питання лікування абдомінального больового синдрому, синдрому зовнішньосекреторної недостатності підшлункової залози, супутніх хронічному панкреатиту дисфункції сфінктера Одді, жовчного міхура, жовчовивідних шляхів, дисбіозу, дискінезії кишечника згідно з положеннями останніх європейських рекомендацій та міжнародних консенсусів.

Elevated Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case Report

Disorders of gall bladder are common and remain as one of the main patients’ chief complaints that might lead to surgical interventions. High level of bilirubin causes gallstones in patients with hereditary spherocytosis (HS). It is often misdiagnosed, because these deposits of bilirubin can be easily broken down in the gallbladder. Gallstones develop in less than half of patients with mild HS and do not always cause symptomatic biliary tract disease. HS is a genetic defect in red blood cells, caused by defects in structural membrane proteins. It is characterized by a decrease the surface area to volume ratio in erythrocytes due to the heterogeneous changes in the various genes that encode for proteins. A 14-year old male was brought to Medical Park hospital/Turki at the emergency room with a sudden onset of pain in the right upper quadrant, vomiting, anemia and jaundice. The patient was diagnosed with gallstone due to obstruction in common bile duct (CBD),with elevated bilirubin as a result for mild HS. This case report study highlight on the role of hereditary spherocytosis in forming many abdominal problem such as gallstone due to high level of heamolysis and elevated of bilirubin. How to Cite this Article Pubmed Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case SRP. 2020; 11(6): 341-346. doi:10.31838/srp.2020.6.54 Web Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case http://www.sysrevpharm.org/?mno=116258 [Access: March 29, 2021]. doi:10.31838/srp.2020.6.54 AMA (American Medical Association) Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case SRP. 2020; 11(6): 341-346. doi:10.31838/srp.2020.6.54 Vancouver/ICMJE Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case SRP. (2020), [cited March 29, 2021]; 11(6): 341-346. doi:10.31838/srp.2020.6.54 Harvard Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein (2020) Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case SRP, 11 (6), 341-346. doi:10.31838/srp.2020.6.54 Turabian Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. 2020. Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case Systematic Reviews in Pharmacy, 11 (6), 341-346. doi:10.31838/srp.2020.6.54 Chicago Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. Elevated Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case Report. Systematic Reviews in Pharmacy 11 (2020), 341-346. doi:10.31838/srp.2020.6.54 MLA (The Modern Language Association) Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein. Elevated Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case Report. Systematic Reviews in Pharmacy 11.6 (2020), 341-346. Print. doi:10.31838/srp.2020.6.54 APA (American Psychological Association) Style Najlaa Abdulameer Ali Al-Dahhan, Hawraa Abdulameer Ali Al-Dahhan, Bayan Jebur Hussein (2020) Bilirubin Level Increase the Risk of Gallstone Disease in Pediatric Hereditary Spherocytosis Patients: A Case Systematic Reviews in Pharmacy, 11 (6), 341-346. doi:10.31838/srp.2020.6.54

Современный взгляд на коморбидность при целиакии: взаимосвязь морфологических изменений слизистой оболочки двенадцатиперстной кишки и формирования билиарной дисфункции

Study Objective: to identify the key clinical and diagnostic markers of comorbidity presenting the risk of biliary pathology in celiac syndrome patients. Study Design: screening observation. Materials and Methods. The study included 133 patients with confirmed celiac syndrome and biliary dysfunction. Subjective clinical symptoms were analysed on the basis of reviews and questionnaires, while objective clinical symptoms were assessed following physical examination. When clinical symptoms were characterised, presence of subjective clinical criteria of functional disorders of gall bladder (GB) and Oddi’s sphincter were assessed. Study Results. Specific markers of biliary dysfunction in patients with celiac syndrome were identified. Following IV Rome criteria (2016), it was determined that subjective symptoms in some patients were signs of biliary indigestion syndrome: aches in right hypochondrium (45.1%), bitter taste in mouth (36.1%), nausea (36.1%). Subject had ultrasound signs on GB pathologies: bends in GB body (31.6%), GB neck (35.3%) and both (33.1%). Celiac syndrome patients had significant correlation between duodenitis severity and morphological characteristic of the major duodenal papilla. Major duodenal papilla inflammation is associated with lymphocytoplasmocytic (44.4%) and leucocytal infiltration (22.6%), dystrophic charges in glandular epithelium, gland hyperplasia (62.9%) (χ2(3) = 48.53; р < 0.001; С = 0.75), demonstrating impact on bile passage. A higher risk of biliary sludge in gall bladder in patients with celiac syndrome is due to GB abnormalities and signs of inflammation and atrophy in major duodenal papilla mucosa and its relation to major duodenal papilla. Conclusion. Our analysis demonstrated that comorbidity in patients with celiac syndrome is associated with biliary dysfunction syndrome. Biliary dysfunction markers are congenital abnormalities in GB structure, that are a result of GB deformation and dyscholia; marked chronic inflammation of major duodenal papilla and duodenum mucosa; stage 3 atrophic changes in duodenum mucosa, according M.N. Marsh. Keywords: celiac syndrome, biliary dysfunction, gall bladder abnormalities, comorbid pathology.

Hospital readmissions among older people with intellectual disability in comparison with the general population.

BackgroundOlder people with intellectual disability have high multimorbidity and poor physical and mental health compared with the general population. Consequently, they have a greater need for health care. Hospital readmissions may be an indicator of the quality of health care. However, so far, only a few studies have investigated this outcome in populations of people with intellectual disability. None has focused on older people.MethodWe identified a cohort of people with intellectual disability aged 55+ years and alive at the end of 2012 (n = 7936). Moreover, we established a reference cohort from the general population, one‐to‐one matched by sex and year of birth. Data on hospital visits during the period 2002–2012 were collected from the Swedish National Patient Register. Readmissions were defined as unplanned visits with the same diagnosis occurring within 30 days of discharge and with no planned visit for the same diagnosis during this time.ResultsCompared with the general population, people with intellectual disability had increased risk of readmissions for diseases of the nervous system [relative risk (RR) 2.62], respiratory system (RR 1.48), digestive system (RR 1.40) and musculoskeletal system and connective tissue (RR 2.10). Within these diagnostic groups, increased risks were found for arthropathies (RR 3.73), disorders of gallbladder, biliary tract and pancreas (RR 1.78), other diseases of intestines (RR 1.30), and other forms of heart disease (RR 1.23). Decreased risk of readmissions was found for mental and behavioural disorders (RR 0.78) and diseases of the circulatory system (RR 0.64).ConclusionsThe increased risk for readmissions related to diseases of the nervous and musculoskeletal systems has a clear relation to the prevalence of comorbidities in these areas. People with intellectual disability often also have inborn limitations and damages in these systems which with time lead to complications and risk for diseases, which can be difficult to discover. The increased risk for readmissions for disease of the respiratory system, together with the already known increased prevalence of such diagnoses and their occurrence as a cause for death, warrants further investigations and considerations of potential preventive measures. The pattern of readmissions among older people with intellectual disability cannot be explained solely by a higher prevalence of disorders in this group. Our finding of increased risks for readmissions for diseases in the digestive system could be interpreted as communication problems, which sometimes result in too rapid discharges and their consequential early readmissions.

Trimebutine maleate in the treatment of functional biliary disorders: TRIBUNE study results

Introduction. The term «functional disorders of the biliary tract and bile ducts» defines the conditions, which produce typical patterns of biliary pains in the absence of obvious signs of organic lesions of the gallbladder and bile ducts. The materials of the Rome IV consensus present the diagnostic criteria of their main types – functional disorders of the gall bladder and sphincter of Oddi. Vasilenko Clinic of Internal Diseases Propedeutics, Gastroenterology and Hepatology of the University Clinical Hospital No. 2 of Sechenov University carried out a noninterventional observational program to study the experience in using Trimedat® (trimebutine maleate) in the routine outpatient and inpatient practice in the treatment of patients with functional diseases of the biliary tract. Information partners of the program are the Russian Gastroenterological Association (RGA) and the Russian Society for the Study of the Liver (RSSL).Materials and methods. The program included patients of both sexes aged 18 to 65 years with ICD-10 diagnoses «spasm of the sphincter of Oddi» (K 83.4), «postcholecystectomy syndrome» (K 91.5), «other specified diseases of the gallbladder» (K 82.8) , «other specified diseases of the bile ducts» (K 83.8), «disorders of gallbladder and biliary tract in diseases classified elsewhere» (K 87.0), if the clinical picture was consistent with functional biliary disorders according to the Rome IV criteria and in cases when the doctor decided to prescribe Trimedat® therapy. Patients were observed for 28 ± 1 days. The dynamics of biliary pain and discomfort, as well as other symptoms (in particular, nausea, flatulence) were evaluated on the background of the therapy, using the Gastrointestinal Symptom Score Scale, in which the severity of each symptom is estimated by 7 grades (Alekseev N.Yu., 2006) with adding a section to evaluate the biliary disorders. In the presence of criteria for functional disorders of the gallbladder, an ultrasound control of the fraction of its discharge was carried out before and after the therapy.Results. 100 patients (33 (33%) men and 67 (67%) women, the average age 42.2 ± 13.2 years (18–65 years)) were enrolled in the program. In accordance with the Rome IV Consensus, the majority of patients (83 (83%)) had the functional disorders of GB; in 16 (16%) patients with the removed GB, the picture corresponded to the functional disorder of SO, one patient with kept GB was diagnosed with SO dysfunction. The treatment with Trimedate® at a standard dosage resulted in a decrease in the proportion of pain in the epigastric region (in the Scale section evaluating the biliary tract symptoms), the degree of nausea and bloating. Differences between the visits were estimated by the Friedman’s test, p <0.001. In addition, other sections of the scale also showed a decrease in indicators in scores. 79 patients underwent repeated ultrasound cholecystography at the end of treatment. It showed an increase in the fraction of GB emptying.Conclusions. The use of Trimedate® in patients with functional disorders of the gall bladder and sphincter of Oddi resulted in the reduction of the severity of the main symptoms - the severity of biliary pain, nausea, bloating. The patients with GB dysfunction showed an increase in the fraction of GB emptying.

Transcriptome analysis of grass carp provides insights into disease-related genes and novel regulation pattern of bile acid feedback in response to lithocholic acid

Gut microbiota and its metabolites affect lipid metabolism and liver health. Grass carp (Ctenopharyngodon idellus) often suffers from functional disorders of liver and gallbladder, which is usually accompanied by accumulation of lipids in the liver. Here we studied liver transcriptome and microbial fluctuation in the gut in response to dietary lithocholic acid (LCA; a metabolite of gut microbiota) supplementation in grass carp. A total of 1802 differentially expressed genes (DEGs) were identified between LCA and Control groups according to the liver transcriptome analysis. Of these DEGs, 8 nonalcoholic fatty liver disease-related genes were all upregulated, and 11 of 12 cancer related genes were upregulated in the LCA group. We also found significantly upregulated bile acid receptor, hepatocyte nuclear factor 4-beta (HNF4B), in the LCA group. The red oil O staining of liver showed a higher abundance of lipid droplets in the LCA group. LCA also changed the composition of gut microbiota, with increasing proportion of Proteobacteria and Firmicutes, whereas Fusobacteria decreased. Co-occurrence between DEGs and microbial taxa was mainly identified between signal transduction and genetic information processing-related genes and Proteobacteria and Firmicutes taxa. Overall, our results elucidate the effects of LCA on liver and gut microbiota in fish, and suggest a novel pattern of bile acid feedback in grass carp. These results contribute to our understanding of the interplay between gut microbiota and liver diseases in fish, and offer insights into putative treatments of liver diseases in grass carp.

Role of Magnetic Resonance Cholangiopancreatography in Biliary Disorders

Magnetic resonance cholangiopancreatography or MRCP is a technique that uses a powerful magnetic field to evaluate the disorders of liver, gallbladder, bile ducts, pancreas and pancreatic duct. This technique was introduced in 1991 & has evolved rapidly over last two decades as it is non-invasive, does not require anaesthesia or contrast enhancing material and is less operator dependent. Although at present endoscopic cholangiopancreatography (ERCP) is the gold standard in evaluating the pancreaticobiliary disorders but is invasive, operator dependent and results in complications such as cholangitis, pancreatitis, haemorrhage and perforation of duodenum which have limited its routine use and has made MRCP as a routine investigation in evaluating biliary tree disorders. Furthermore MRCP is superior to ERCP in diagnosing the biliary disorders in the settings where biliary anatomy is distorted due to previous pancreatic biliary surgeries. MRCP is a technique that uses heavily weighted T2 sequences which highly enhances static or slowly flowing bile against non-enhancing surrounding soft tissue which makes the evaluation of biliary tree more accurate and easy.

Standards for diagnosis gastrointestinal motility disorders. Section: ultrasonography position statement from the Gruppo Italiano di Studio Motilità Apparato Digerente (GISMAD)

Ultrasonography is a non-invasive, relatively easy, validated and reproducible technique. We assessed the usefulness of functional ultrasonography to study disorders of gastro-oesophageal tract, gallbladder and pancreatic duct. Oesophagus Oesophagus and the gastro-oesophageal junction can be visualized in children up to 5 years old. Ultrasonography shows 100% sensitivity and 87.5% specificity compared to ambulatory pH-metry for gastro-oesophageal reflux disease diagnosis. Stomach Ultrasonography can be used to estimate whole gastric volume, antral area or diameters, antro pyloric volume, transpyloric flow in fasting state and in response to test meal. Gallbladder Ul-trasonography is reliable to estimate volume in fasting state and in response to test meal or exogenous stimulus. For both stomach and gallbladder, indications might include the study of healthy subjects and of pathophysiologically relevant conditions such as dysmotility-like dyspepsia, suspicion of delayed gastric emptying, diabetes mellitus, gallstone disease and effect of drugs either delaying or accelerating motility. Common bile duct Ultrasonography can be used to estimate interprandial and postprandial common bile duct diameter in patients with clinical suspicion of common bile duct obstruction in fasting state and in response to test meal or exogenous stimuli. Although functional ultrasonography is used mainly for research purposes, its simplicity makes it appealing for clinical use to assess gastrointestinal motility in health and disease.