Paula Viñas
José de Felippe Junior

Cólica Biliar

Também conhecida como colelitíase, calculose biliar; cólica de vesícula, cólica de fígado, pedra na vesícula.

A colelitíase é a formação de pedras nas vias biliares, em particular na vesícula biliar. O fígado fabrica a bile, que por sua vez ajuda na digestão dos alimentos (emulsificação das gorduras). Uma parte da secreção biliar proveniente do fígado passa primeiramente, pela vesícula biliar onde sofre processo de concentração.

Quando a bile se encontra excessivamente rica em colesterina, cálcio e bilirrubina pode acontecer a formação e a precipitação de microcristais, na grande maioria das vezes, dentro da vesícula biliar. Estes vão crescendo pelo acúmulo de novas camadas podendo alcançar milímetros a centímetros de diâmetro.

Os canais biliares dificultam o trânsito dos cálculos, e quando se obstruem temos a cólica biliar.

O sexo feminino está muito mais propenso a este tipo de enfermidade. A obesidade também é um fator: apenas 1/3 dos indivíduos magros possuem a enfermidade. Sua freqüência diminuiu notavelmente durante os anos de fome na segunda guerra mundial. Outro fator de propensão é o diabete melito e a cirrose.

Bibliografia consultada:

Valenti, P Farreras Medicina Interna Compendio Pratico da Patologia Medica 7º edição Espanha: editorial Marin S/A 1967.

Alcachofra

Anticholestatic activity of flavonoids from artichoke (Cynara scolymus L.) and of their metabolites.
Med Sci Monit. 2001 May;7 Suppl 1:316-20.
Gebhardt R.
Institut fur Biochemie, Universitatsklinikum Leipzig, Germany. rgebhardt@medizin.uni-leipzig.de

It is well known that water-soluble extracts of artichoke (Cynara scolymus L.) leaves exert choleresis. When studying this effect in vitro using primary cultured rat hepatocytes and cholephilic fluorescent compounds, it was noticed that the artichoke leaf extracts not only stimulated biliary secretion, but that they also reestablished it when secretion was inhibited by addition of taurolithocholate to the culture medium. Furthermore, taurolithocholate-induced bizarre bile canalicular membrane distortions detectable by electron microscopy could be prevented by artichoke leaf extracts in a dose-dependent manner when added simultaneously with the bile acid. These effects were exerted by the flavonol luteolin and, to a lesser extent, by luteolin-7-O-glucoside, while chlorogenic acid and 1.5-dicaffeoyl quinic acid were almost ineffective. Surprisingly, metabolites produced by the cultured hepatocytes were able to stimulate biliary secretion substantially as well as prevent canalicular membrane deformation. These results demonstrate that artichoke leaf extracts exert a potent anticholestatic action at least in the case of taurolithocholate-induced cholestasis. Flavonoids and their metabolites may contribute significantly to this effect.

Choleretic activity and biliary elimination of lipids and bile acids induced by an artichoke leaf extract in rats.

Phytomedicine. 2002 Dec;9(8):687-93.
Saenz Rodriguez T, Garcia Gimenez D, de la Puerta Vazquez R.
Pharmacology Department, Faculty of Pharmacy, University of Seville, Seville, Spain.

The therapeutic properties of artichoke (Cynara scolymus L.) preparations have been known since ancient times. The traditional use of artichoke leaf extract (ALE) in gastroenterology is mainly based upon its strong antidyspeptic actions which are mediated by its choleretic activity. The aim of this study was to investigate the effects of ALE on bile flow and the formation of bile compounds in anaesthetised Wistar rats after acute and repeated (twice a day for 7 consecutive days) oral administration. A significant increase in bile flow was observed after acute treatment with ALE as well as after repeated administration. The choleretic effects of ALE were similar to those of the reference compound dehydrocholic acid (DHCA). Total bile acids, cholesterol and phospholipid were determined by enzymatic assays. There was a strong ALE-induced increase in total bile acid concentration over the entire experiment. With the highest dose (400 mg/kg), a significant increase was obtained after single and repeated administration. The bile acids-increased effects of ALE were much more pronounced than those of reference (DHCA). No significant differences in cholesterol and phospholipid content could be found.