Step I gallstones and TPN?

[MudPhud20XX]

FA says total parenteral nutrition is one of the causes for cholelithiasis (gallstones), can anyone explain this pls?

 

[TheBDP]

No nutrients reaching the gut-->no secretin, CCK, etc-->no bile acid secretion-->cholesterol build up

just a guess, but I think it makes sense

 

[zhopv10]

Just checked it out on merk manual and as thebdp mentioned it seems largely due to the stasis, so it is controlled by providing 20-30% of calories from fat and stopping glucose infusion several hrs per day apparently. Oral or enteral intake helps of course and you can tx with metronidazole, ursodeoxycholic acid, phenobarbital, or CCK and that can help.


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