Original Research

Fatty meal sonography comparing coconut oil and chocolate bar with full-fat yoghurt as cholecystagogues for gallbladder ejection fractions

Benjamin Spangenberg, Jacques Janse van Rensburg
South African Journal of Radiology | Vol 22, No 1 | a1312 | DOI: https://doi.org/10.4102/sajr.v22i1.1312 | © 2018 Benjamin Spangenberg | This work is licensed under CC Attribution 4.0
Submitted: 31 January 2018 | Published: 18 June 2018

About the author(s)

Benjamin Spangenberg, Department of Radiology, University of the Free State, South Africa; Department of Clinical Imaging Sciences, Universitas Hospital, South Africa
Jacques Janse van Rensburg, Department of Clinical Imaging Sciences, Universitas Hospital, South Africa

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Background: The authors compared the effectiveness of a chocolate bar and full-fat yoghurt combination to coconut oil in determining the gallbladder ejection fraction (GBEF). The clinical motive was functional gallbladder disorder (FGD) which has the clinical picture of symptomatic gallstones but without gallstones. Functional gallbladder disorder has a decreased GBEF of less than 35%. Gallbladder ejection fraction can be calculated by ultrasound, using cholecystokinin (CCK) as a stimulant for gallbladder contraction. Cholecystokinin is not available in South Africa, and the researchers compared a 60 g Snickers chocolate bar with 200 g full-fat yoghurt, against the theoretically superior coconut oil.


Objectives: To determine the efficacy of coconut oil versus chocolate bar and 200 g full-fat yoghurt combination in performing sonographic GBEFs.


Method: This was a randomised clinical experiment, before and after crossover trial. The three experimental components of the study included 15 g coconut oil, 20 g coconut oil and a standard fatty meal consisting of 60 g Snickers bar and 200 g full-fat yoghurt.


Results: The GBEF for the chocolate bar and yoghurt combination was the highest (62.84%). The GBEF for 20 g of coconut oil was 23.47% and for 15 g of coconut oil was 5.11%. There was a statistically significant difference between the chocolate and yoghurt combination and the 20 g coconut oil, as well as the chocolate yoghurt combination and the 15 g coconut oil, both with a p-value of < 0.0001. No statistically significant difference was found between the 20 g and 15 g coconut oil.


Conclusions: The 60 g Snickers chocolate bar and 200 g full-fat yoghurt combination was superior to the coconut oil. The authors advocate using the chocolate and yoghurt fatty meal oral stimulant to determine GBEF.



functional gallbladder disorder; gallbladder ejection fraction; fatty meal;chronic acalculous cholecystitis


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