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Archived Comments for: Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases

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  1. Inherited lythiasis biophysical-semeiotic constitution and lythiasis real risk.

    Sergio Stagnaro, Biophysical Semeiotics Research Laboratory

    21 August 2007

    Bed-side diagnosis of the cholelithiasis is mainly difficult, due to the fact that the clinical phenomenology either is completely absent (“silent gall-bladder stones”) or, if present, it is aspecific and, therefore, not easy to be correctly interpreted. Obviously, more difficult is recognizing at the bed-side both silent stones, i.e. gall-bladder stones without any clinical symptomatology, cholecyst diseases with light, not severe, symptomatology, and particularly lythiasis biophysical-semeiotic constitution and lythiasis real risk.

    Unfortunately, until now doctors were not able to identify individuals apparently healthy but at “real” risk of gall-bladder stones, as well as the “variant” Reavens syndrome, which represents the conditio sine qua non of lithiasis in whatever biological system, including arterial wall, obviously in presence of inherited lythiasis biophysical-semeiotic constitution (1-5).

    As following, simple biophysical semeiotic signs, reliable in prompt recognizing both this sometime dangerous cholecyst disease and the “real” risk of cholelithiasis, in a “quatitative” manner, easily recognizable with the aid of Biophysical Semeiotics, are briefly described. Surely, by means of the old, traditional semeiotics, bed-side diagnosing such as disorder disorder is rather difficult until now.

    In fact, with the aid Biophysical Semeiotics (1-3), based on auscultatory percussion, doctor is able to recognize promptly not only gall-bladder stones, even clinicallly silent, but also, for the first time to my knowledge, the individuals at “real” risk of them, with favorable influence on primary prevention.

    In order to perform this biophysical semeiotic procedure, doctor has to know, at least, the auscultatory percussion of the stomach (Fig.1). (For further information, See Practical Applications).

    The knowledge of liver and gall-bladder auscultatory percussion , of course, enlightens and enriches this method of examination (1).

    In healthy, without “risk” for stones, i.e., in absence of “variant” Reaven’s syndrome digital pressure, applied upon the skin projection area of gall-bladder, i.e. right superior abdominal quadrant, preferebly delimitated as indicates Fig. 1, provokes the so-called "gastric aspecific reflex" (= in the stomach, fundus and body dilate; on the contrary, antral-pyloric region contracts), as clearly indicated in Fig 1, after latency time of 8 sec. exactly: intensity < 2 cm. Physiologically, the reflex persists identical for less than 4 sec. and finally disappears for > 3 sec. < 4 sec.: this value parallels the fractal dimension of local microvessel fluctuations, calculated in a sophysticated manner.

    Interestingly, in case of gall-bladder stone(s), even clinically silent, the latency time is shorter (< 8 sec.), intensity is 2 cm. or more (in relation to disorder entity) and, soon thereafter, characteristically its intensity decreases rapidly of 1/3 of greatest intensity: "lythiasic reflex", observed also during stimulation of specific trigger-points, in case of other stones and calcium deposition, localized in whatever biological system, including kidneys and arterial wall.

    It seems really interesting the fact that, if patient performs the Valsalva's manouvre, due to abdominal pressure increase, the reflex appears spontaneously in the same manner, described above. This evaluation is, however,less specific than the first one.

    Moreover, the reliable "gall-bladder preconditioning" (2) provides usefull information: after an interruption of exact 5 sec., doctor carries out a second (and third) evaluation. In healthy, the latency time turns out lenghtened (latency time = 10-12 sec. versus 8 sec.).

    On the contrary, in both “real” risk for gall-bladder-stones and cholelythiasis, the latency time of gastric aspecific reflex is either identical in initiasl stage to basal value (which can be apparently normal, i.e., 8 sec.), or shorter (latency less than 8 sec.), in relation to disease seriousness. In any case, reflex duration is 4 sec. or more: parameter value of central importance from the diagnostic viewpoint. The physio-pathology of the biophysical-semeiotic signs is based upon microvascular conditions of the gall-bladder wall, according to

    Further interesting signs of gall-bladder stones are fully described elsewehre in previous papers as the cholelithyasic constitution (1-6).

    Due to reader’s knowledge of Biophysical Semeiotics, unfortunately, clinical microangiological signs are at the moment not referred in this paper. (For further information See: http:// In conclusion, in my opinion,Helicobacter species may play only the role of a risk factor of the disorder!


    1. Stagnaro S., Stagnaro-Neri M., Diagnosi percusso-ascoltatoria dei calcoli biliari silenti. 6 ° Incontro Segusino di Medicina e Chirurgia. Susa 19 Maggio, 1990. Atti, pg. 79. Ed. Minerva Medica, Torino.1990

    2. Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ed. Travel Factory, Roma, 2004.

    3. Stagnaro-Neri M., Stagnaro S., La "Costituzione Colelitiasica": ICAEM-a, Sindrome di Reaven variante e Ipotonia-Ipocinesia delle vie biliari. Atti. XII Settim. It. Dietol. 20, 239, 1993

    4. Stagnaro-Neri M., Stagnaro S., La sindrome dispeptica funzionale da discinesia delle vie biliari. Diagnosi percusso-ascoltatoria. Cin. Ter. 127, 363, 1988 (Medline)

    5. Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617, 1993.

    6) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005.

    Competing interests

    None declared