Gallstones symptoms are not uncommon in the U.S. as gallstone disease is frequently diagnosed, especially among women, who are treated for the disease more frequently than men. Gallstone symptoms in women may be more common because the disease often results from rapid weight loss and obesity and frequently occurs after childbirth. Not only that, removal of the gallbladder or cholecystectomy is performed on over 500,000 people annually.
An Attack that Occurs without Warning
The gallbladder’s role is to assist in digestion as well as fat absorption in the first part of the small intestine. It also acts to store bile manufactured by the liver. Gallstones are usually made up of salts from bile as well as cholesterol. When gall stones form then, it often results in an attack, suddenly occurring without any type of warning. Gallstones signs and symptoms can include:
An intense pain in the upper part of the stomach area that worsens and can last anywhere from a half hour to a couple hours.
A pain between the shoulder blades and beneath the shoulder on the right side.
Nausea and vomiting.
Other Gallstone Symptoms
Such full-blown attacks will often follow a meal that consists of foods that are high in fat. It typically happens during the nighttime hours. There are other gallstones signs and symptoms that regularly occur too, such as:
Colic
The inability to eat any foods containing fat
Bloating that won’t subside
Severe stomach upset
Belching
Gallstones Symptoms in Women
Symptoms of gallstones in women often are underscored by stomach upset and vomiting, which some women can confuse with certain premenstrual symptoms. In serious cases, gallstone sufferers will experience the following symptomology, and should seek immediate medical aid:
Fever
Chilling as well as sweating
A yellow cast to the whites of the eyes or the skin
Gallstone Disease without Symptoms
In other cases gallstone symptoms in women and men are non-existent. Calculi in these instances, although produced in the gallbladder, may end up in other nearby areas other than the gallbladder, such as the pancreatic duct or cystic duct. However, gallstones that remain in the gallbladder (or cholelithiasis) can be the basis for cholecystitis, a life-threatening medical condition.
Health Tips – Preventing Gallbladder Disease
Gallstone disease can be prevented by eating a diet that is low in fats and cholesterol. Fresh fruits and vegetables are recommended as well as a lower consumption of processed foods and baked goods. Avoiding foods containing trans fats or saturated fats, such as butter, can do a lot in preventing gallbladder difficulties in the long run. Therefore, nutrition should consist of vegetables, fruits, whole grains, lean meats, and low-fat dairy. Any foods with monounsaturated fats or polyunsaturated fats are safe as these kinds of foods wash away the bad LDL cholesterol out of the blood and reduce the possibility of the formation of future stones.
Sunday, November 18, 2012
Saturday, November 17, 2012
Gallstones
Gallstones Overview
Gallstones (commonly misspelled gall stones or gall stone) are solid particles that form from bile in the gallbladder.
The gallbladder is a small saclike organ in the upper right part of the abdomen. It is located under the liver, just below the front rib cage on the right side.
The gallbladder is part of the biliary system, which includes the liver and the pancreas.
The biliary system, among other functions, produces bile and digestive enzymes.
Bile is a fluid made by the liver to help in the digestion of fats.
It contains several different substances, including cholesterol and bilirubin, a waste product of normal breakdown of blood cells in the liver.
Bile is stored in the gallbladder until needed.
When we eat a high-fat, high-cholesterol meal, the gallbladder contracts and injects bile into the small intestine via a small tube called the common bile duct. The bile then assists in the digestive process.
There are two types of gallstones: 1) cholesterol stones and 2) pigment stones.
Patients with cholesterol stones are more common in the United States; cholesterol stones make up approximately 80% of all gallstones. They form when there is too much cholesterol in the bile.
Pigment stones form when there is excess bilirubin in the bile.
Gallstones can be any size, from tiny as a grain of sand to large as a golf ball.
Although it is common to have many smaller stones, a single larger stone or any combination of sizes is possible.
If stones are very small, they may form a sludge or slurry.
Whether gallstones cause symptoms depends partly on their size and their number, although no combination of number and size can predict whether symptoms will occur or the severity of the symptoms.
Gallstones within the gallbladder often cause no problems. If there are many or they are large, they may cause pain when the gallbladder responds to a fatty meal. They also may cause problems if they move out of the gallbladder.
If their movement leads to blockage of any of the ducts connecting the gallbladder, liver, or pancreas with the intestine, serious complications may result.
Blockage of a duct can cause bile or digestive enzymes to be trapped in the duct.
This can cause inflammation and ultimately severe pain, infection, and organ damage.
If these conditions go untreated, they can even cause death.
Up to 20% of adults in the United States may have gallstones, yet only 1% to 3% develop symptoms.
Hispanics, Native Americans, and Caucasians of Northern European descent are most likely to be at risk for gallstones. African Americans are at lower risk.
Gallstones are most common among overweight, middle-aged women, but the elderly and men are more likely to experience more serious complications from gallstones.
Women who have been pregnant are more likely to develop gallstones. The same is true for women taking birth control pills or on hormone/estrogen therapy as this can mimic pregnancy in terms of hormone levels.
Gallstones Causes
Gallstones occur when bile forms solid particles (stones) in the gallbladder.
The stones form when the amount of cholesterol or bilirubin in the bile is high.
Other substances in the bile may promote the formation of stones.
Pigment stones form most often in people with liver disease or blood disease, who have high levels of bilirubin.
Poor muscle tone may keep the gallbladder from emptying completely. The presence of residual bile may promote the formation of gallstones.
Risk factors for the formation of cholesterol gallstones include the following:
female gender,
being overweight,
losing a lot of weight quickly on a "crash" or starvation diet, or
taking certain medications such as birth control pills or cholesterol lowering drugs.
Gallstones are the most common cause of gallbladder disease.
As the stones mix with liquid bile, they can block the outflow of bile from the gallbladder. They can also block the outflow of digestive enzymes from the pancreas.
If the blockage persists, these organs can become inflamed. Inflammation of the gallbladder is called cholecystitis. Inflammation of the pancreas is called pancreatitis.
Contraction of the blocked gallbladder causes increased pressure, swelling, and, at times, infection of the gallbladder.
When the gallbladder or gallbladder ducts become inflamed or infected as the result of stones, the pancreas frequently becomes inflamed too.
This inflammation can cause destruction of the pancreas, resulting in severe abdominal pain.
Untreated gallstone disease can become life-threatening, particularly if the gallbladder becomes infected or if the pancreas becomes severely inflamed.
Gallstones and Diet
The role of diet in the formation of gallstones is not clear.
We do know that anything that increases the level of cholesterol in the blood increases the risk of gallstones.
It is reasonable to assume that a diet with large amounts of cholesterol and other fats increases the risk of gallstones, but it is also important to remember that the amount of cholesterol in your bile has no relationship to your blood cholesterol.
Loosing weight rapidly seems to increase the risk of gallstones and so does skipping meals.
Obesity is a risk factor for gallstones.
Eating a fatty or greasy meal can precipitate the symptoms of gallstones.
Gallstones (commonly misspelled gall stones or gall stone) are solid particles that form from bile in the gallbladder.
The gallbladder is a small saclike organ in the upper right part of the abdomen. It is located under the liver, just below the front rib cage on the right side.
The gallbladder is part of the biliary system, which includes the liver and the pancreas.
The biliary system, among other functions, produces bile and digestive enzymes.
Bile is a fluid made by the liver to help in the digestion of fats.
It contains several different substances, including cholesterol and bilirubin, a waste product of normal breakdown of blood cells in the liver.
Bile is stored in the gallbladder until needed.
When we eat a high-fat, high-cholesterol meal, the gallbladder contracts and injects bile into the small intestine via a small tube called the common bile duct. The bile then assists in the digestive process.
There are two types of gallstones: 1) cholesterol stones and 2) pigment stones.
Patients with cholesterol stones are more common in the United States; cholesterol stones make up approximately 80% of all gallstones. They form when there is too much cholesterol in the bile.
Pigment stones form when there is excess bilirubin in the bile.
Gallstones can be any size, from tiny as a grain of sand to large as a golf ball.
Although it is common to have many smaller stones, a single larger stone or any combination of sizes is possible.
If stones are very small, they may form a sludge or slurry.
Whether gallstones cause symptoms depends partly on their size and their number, although no combination of number and size can predict whether symptoms will occur or the severity of the symptoms.
Gallstones within the gallbladder often cause no problems. If there are many or they are large, they may cause pain when the gallbladder responds to a fatty meal. They also may cause problems if they move out of the gallbladder.
If their movement leads to blockage of any of the ducts connecting the gallbladder, liver, or pancreas with the intestine, serious complications may result.
Blockage of a duct can cause bile or digestive enzymes to be trapped in the duct.
This can cause inflammation and ultimately severe pain, infection, and organ damage.
If these conditions go untreated, they can even cause death.
Up to 20% of adults in the United States may have gallstones, yet only 1% to 3% develop symptoms.
Hispanics, Native Americans, and Caucasians of Northern European descent are most likely to be at risk for gallstones. African Americans are at lower risk.
Gallstones are most common among overweight, middle-aged women, but the elderly and men are more likely to experience more serious complications from gallstones.
Women who have been pregnant are more likely to develop gallstones. The same is true for women taking birth control pills or on hormone/estrogen therapy as this can mimic pregnancy in terms of hormone levels.
Gallstones Causes
Gallstones occur when bile forms solid particles (stones) in the gallbladder.
The stones form when the amount of cholesterol or bilirubin in the bile is high.
Other substances in the bile may promote the formation of stones.
Pigment stones form most often in people with liver disease or blood disease, who have high levels of bilirubin.
Poor muscle tone may keep the gallbladder from emptying completely. The presence of residual bile may promote the formation of gallstones.
Risk factors for the formation of cholesterol gallstones include the following:
female gender,
being overweight,
losing a lot of weight quickly on a "crash" or starvation diet, or
taking certain medications such as birth control pills or cholesterol lowering drugs.
Gallstones are the most common cause of gallbladder disease.
As the stones mix with liquid bile, they can block the outflow of bile from the gallbladder. They can also block the outflow of digestive enzymes from the pancreas.
If the blockage persists, these organs can become inflamed. Inflammation of the gallbladder is called cholecystitis. Inflammation of the pancreas is called pancreatitis.
Contraction of the blocked gallbladder causes increased pressure, swelling, and, at times, infection of the gallbladder.
When the gallbladder or gallbladder ducts become inflamed or infected as the result of stones, the pancreas frequently becomes inflamed too.
This inflammation can cause destruction of the pancreas, resulting in severe abdominal pain.
Untreated gallstone disease can become life-threatening, particularly if the gallbladder becomes infected or if the pancreas becomes severely inflamed.
Gallstones and Diet
The role of diet in the formation of gallstones is not clear.
We do know that anything that increases the level of cholesterol in the blood increases the risk of gallstones.
It is reasonable to assume that a diet with large amounts of cholesterol and other fats increases the risk of gallstones, but it is also important to remember that the amount of cholesterol in your bile has no relationship to your blood cholesterol.
Loosing weight rapidly seems to increase the risk of gallstones and so does skipping meals.
Obesity is a risk factor for gallstones.
Eating a fatty or greasy meal can precipitate the symptoms of gallstones.
Gallbladder Diet
Experts discuss foods that are good for your gallbladder, as well as what not to eat when you have gallbladder problems.
By Stephanie Watson
WebMD Feature
Reviewed by Venkat Mohan, MD
Most people never give a thought to the health of their gallbladder. The pear-shaped organ does have an important job, collecting and storing bile -- the fluid that helps the body digest fats. But unlike the heart, liver, and kidneys, the gallbladder isn't necessary to keep the body healthy and functioning. Even when it isn't working as well as it should and gallstones develop, most people are unaware that there is a problem.
Yet in a small percentage of people, gallstones can trigger a variety of symptoms, such as abdominal pain, bloating, nausea, and vomiting. When gallstone symptoms are frequent, recurrent, and especially uncomfortable, the typical treatment is surgery to remove the gallbladder.
"The majority of people with gallstones never develop symptoms their whole lives," says John Martin, MD, associate professor of medicine and surgery, and director of endoscopy at the Northwestern University Feinberg School of Medicine. "Once you start to develop symptoms, you're going to need to have the gallbladder taken out."
Although diet doesn't directly cause gallbladder problems -- and it won't cure them -- watching what you eat and keeping a healthy weight might help you prevent gallstones from forming and avoid some discomfort if you do develop gallstones.
Diet and Gallstone Risk
A number of risk factors contribute to the formation of gallstones, including a family history of gallstones and gender. Women are twice as likely as men to develop them. Body weight is also a factor; the risk of gallstones is higher in people who are overweight and obese.
Diets that are high in fat and cholesterol and low in fiber appear to play a role. "There's a lot of things you can't change in that list, but you can certainly influence your diet," says F. Taylor Wootton III, MD, clinical counselor, associate professor of internal medicine at Eastern Virginia Medical School, and a member of the American Gastroenterological Association governing board.
If you're overweight, try to lose the extra weight; but do it gradually. There is a link between quick weight loss and gallstone formation. Crash or "yo-yo" diets can cause the liver to release more cholesterol into the bile, disrupting the normal balance of cholesterol and bile salts. That extra cholesterol can form into crystals, leading to gallstones, Wootton says.
Healthy Foods for the Gallbladder
Whether or not you are at risk for gallstones, it's always a good idea to keep your body at a healthy weight and eat a diet that is low in fat and cholesterol, moderate in calories, and high in fiber.
All of the following are healthy foods for your gallbladder, as well as the rest of your body:
Fresh fruits and vegetables
Whole grains (whole-wheat bread, brown rice, oats, bran cereal)
Lean meat, poultry, and fish
Low-fat dairy products
Certain foods have been studied for their potential to prevent gallbladder problems or reduce symptoms. For example, some research has indicated that drinking caffeinated coffee lowers the risk of gallstones in both men and women. Drinking moderate amounts of alcohol has also been linked to a reduced incidence of gallstones. In one study, women who ate at least one serving of peanuts a day had a 20% lower chance of having their gallbladder removed compared to women who rarely ate peanuts or peanut butter.
However, keep in mind the evidence is far too preliminary at this time to recommend any of these foods solely for the purpose of preventing gallbladder problems.
Foods to Avoid With Gallbladder Problems
Researchers say many gallbladder symptoms stem from the modern Western diet, which is high in refined carbohydrates and saturated fats. "If you're having symptoms from gallstones, its because as your gallbladder tries to squeeze, some of the gallstone is blocking the outflow of bile that is stored in your gallbladder," Martin says. "You're squeezing against a closed door, and that's why it hurts. If you eat fatty foods, that makes it squeeze more."
Changing your diet won't get rid of gallstones that are already there, but eating a healthy, balanced variety of nutrients and limiting the amount of saturated fats and cholesterol-heavy foods you eat may help ease your symptoms.
Try to avoid or limit these high-fat foods in your diet:
Fried foods
Highly processed foods (doughnuts, pie, cookies)
Whole-milk dairy products (cheese, ice cream, butter)
Fatty red meat
Also steer clear of very low-calorie diets. If you are overweight, aim for a gradual weight loss of 1 to 2 pounds a week by sticking to a healthy, well-balanced diet and getting regular exercise. Always diet under your doctor's supervision.
If you continue to have symptoms, see your doctor. You may need surgery to have your gallbladder removed.
SOURCES:
John Martin, MD, associate professor of medicine and surgery and director of endoscopy, Northwestern University Feinberg School of Medicine.
F. Taylor Wootton III, MD, clinical counselor, associate professor of internal medicine, Eastern Virginia Medical School; member, American Gastroenterological Association governing board.
Leitzmann, M.F. American Journal of Clinical Nutrition, 2003; vol 78: pp 339-347.
Cuevas, A. American College of Nutrition, 2004; vol 23: pp 187-196.
Giovannucci, E.L. American Journal of Clinical Nutrition, 2004; vol 80: pp 76-81.
Rakel, D. Integrative Medicine. 2nd ed., Saunders Elsevier, 2007.
Feldman M, Friedman L.S., Brandt L.J. Sleisenger & Fordtran's Gastrointestinal & Liver Disease, 8th ed., Saunders Elsevier, 2006.
Reviewed on August 24, 2011 © 2009 WebMD, LLC. All rights reserved.
By Stephanie Watson
WebMD Feature
Reviewed by Venkat Mohan, MD
Most people never give a thought to the health of their gallbladder. The pear-shaped organ does have an important job, collecting and storing bile -- the fluid that helps the body digest fats. But unlike the heart, liver, and kidneys, the gallbladder isn't necessary to keep the body healthy and functioning. Even when it isn't working as well as it should and gallstones develop, most people are unaware that there is a problem.
Yet in a small percentage of people, gallstones can trigger a variety of symptoms, such as abdominal pain, bloating, nausea, and vomiting. When gallstone symptoms are frequent, recurrent, and especially uncomfortable, the typical treatment is surgery to remove the gallbladder.
"The majority of people with gallstones never develop symptoms their whole lives," says John Martin, MD, associate professor of medicine and surgery, and director of endoscopy at the Northwestern University Feinberg School of Medicine. "Once you start to develop symptoms, you're going to need to have the gallbladder taken out."
Although diet doesn't directly cause gallbladder problems -- and it won't cure them -- watching what you eat and keeping a healthy weight might help you prevent gallstones from forming and avoid some discomfort if you do develop gallstones.
Diet and Gallstone Risk
A number of risk factors contribute to the formation of gallstones, including a family history of gallstones and gender. Women are twice as likely as men to develop them. Body weight is also a factor; the risk of gallstones is higher in people who are overweight and obese.
Diets that are high in fat and cholesterol and low in fiber appear to play a role. "There's a lot of things you can't change in that list, but you can certainly influence your diet," says F. Taylor Wootton III, MD, clinical counselor, associate professor of internal medicine at Eastern Virginia Medical School, and a member of the American Gastroenterological Association governing board.
If you're overweight, try to lose the extra weight; but do it gradually. There is a link between quick weight loss and gallstone formation. Crash or "yo-yo" diets can cause the liver to release more cholesterol into the bile, disrupting the normal balance of cholesterol and bile salts. That extra cholesterol can form into crystals, leading to gallstones, Wootton says.
Healthy Foods for the Gallbladder
Whether or not you are at risk for gallstones, it's always a good idea to keep your body at a healthy weight and eat a diet that is low in fat and cholesterol, moderate in calories, and high in fiber.
All of the following are healthy foods for your gallbladder, as well as the rest of your body:
Fresh fruits and vegetables
Whole grains (whole-wheat bread, brown rice, oats, bran cereal)
Lean meat, poultry, and fish
Low-fat dairy products
Certain foods have been studied for their potential to prevent gallbladder problems or reduce symptoms. For example, some research has indicated that drinking caffeinated coffee lowers the risk of gallstones in both men and women. Drinking moderate amounts of alcohol has also been linked to a reduced incidence of gallstones. In one study, women who ate at least one serving of peanuts a day had a 20% lower chance of having their gallbladder removed compared to women who rarely ate peanuts or peanut butter.
However, keep in mind the evidence is far too preliminary at this time to recommend any of these foods solely for the purpose of preventing gallbladder problems.
Foods to Avoid With Gallbladder Problems
Researchers say many gallbladder symptoms stem from the modern Western diet, which is high in refined carbohydrates and saturated fats. "If you're having symptoms from gallstones, its because as your gallbladder tries to squeeze, some of the gallstone is blocking the outflow of bile that is stored in your gallbladder," Martin says. "You're squeezing against a closed door, and that's why it hurts. If you eat fatty foods, that makes it squeeze more."
Changing your diet won't get rid of gallstones that are already there, but eating a healthy, balanced variety of nutrients and limiting the amount of saturated fats and cholesterol-heavy foods you eat may help ease your symptoms.
Try to avoid or limit these high-fat foods in your diet:
Fried foods
Highly processed foods (doughnuts, pie, cookies)
Whole-milk dairy products (cheese, ice cream, butter)
Fatty red meat
Also steer clear of very low-calorie diets. If you are overweight, aim for a gradual weight loss of 1 to 2 pounds a week by sticking to a healthy, well-balanced diet and getting regular exercise. Always diet under your doctor's supervision.
If you continue to have symptoms, see your doctor. You may need surgery to have your gallbladder removed.
SOURCES:
John Martin, MD, associate professor of medicine and surgery and director of endoscopy, Northwestern University Feinberg School of Medicine.
F. Taylor Wootton III, MD, clinical counselor, associate professor of internal medicine, Eastern Virginia Medical School; member, American Gastroenterological Association governing board.
Leitzmann, M.F. American Journal of Clinical Nutrition, 2003; vol 78: pp 339-347.
Cuevas, A. American College of Nutrition, 2004; vol 23: pp 187-196.
Giovannucci, E.L. American Journal of Clinical Nutrition, 2004; vol 80: pp 76-81.
Rakel, D. Integrative Medicine. 2nd ed., Saunders Elsevier, 2007.
Feldman M, Friedman L.S., Brandt L.J. Sleisenger & Fordtran's Gastrointestinal & Liver Disease, 8th ed., Saunders Elsevier, 2006.
Reviewed on August 24, 2011 © 2009 WebMD, LLC. All rights reserved.
Gallstones - Symptoms - Treatments - Prevention
Gallstones are the most common and costly digestive disease in the United States, causing more than 800,000 hospitalizations annually at estimated cost of over five billion dollars. More than 20 million Americans have gallstones and approximately one million new cases are diagnosed each year. Women are twice as likely as men to develop gallstones; the higher prevalence of gallstones in women is thought to be caused by multiple pregnancies, obesity, and rapid weight loss. Well over half a million people undergo cholecystectomy (surgical removal of the gallbladder) each year.
The normal function of the gallbladder is to store bile produced by the liver, and to aid in the digestion and absorption of fats in the duodenum (the first portion of the small intestine). Gallstones compose a solid formation of cholesterol and bile salts. However, research shows that approximately 80 to 90 percent of all gallstones are cholesterol gallstones which form when the liver begins secreting bile that is abnormally saturated with cholesterol. The excess cholesterol crystallizes and then forms stones which are stored in the gallbladder or the cystic duct. Gallstones can also form due to low levels of bile acids and bile lecithin.
Who Is At Risk For Gallstones?
When I was diagnosed with gallstones at 26, I was told that the typical gallstone patient was fair, fat, and forty. Today gallstones are seen in younger patients, perhaps due to the large amount of fast foods being consumed. My daughter went through five years of vomiting beginning at age 15, leading me to almost believe that she was bulimic, before she was diagnosed with gallstones at age 20. Risk factors which can lead to increased incidence of gallstones include the "Four Fs:" fat, female, fertile, and flatulent, as well as sickle cell disease (bilirubin), cirrhosis, Crohn's disease, diabetes, pancreatic disease, and hyperparathyroidism.
When the symptoms of gallstones occur they are often called an "attack" because they occur suddenly. The typical gallstone attack includes: •Steady, severe pain in the upper abdomen that increases rapidly and lasts from 30 minutes to several hours.
•Pain in the back between the shoulder blades.
•Pain under the right shoulder.
•Nausea or vomiting.
Gallstone attacks often follow fatty meals, and they may occur during the night. Although I was lucky not to have too much nausea and vomiting with my gallstones, one of my most vivid childhood memories is of my mother up at night, in the bathroom, vomiting.
Other symptoms of gallstones include:
•Abdominal bloating.
•Recurring intolerance of fatty foods.
•Colic.
•Belching.
•Gas.
•Indigestion.
The following symptoms are indication that you should seek immediate medical attention:
•Sweating.
•Chills.
•Low-grade fever.
•Yellowish color of the skin or whites of the eyes.
•Clay-colored stools.
Many people have gallstones with no symptoms, these people are called asymptomatic. Gallstones that cause no symptoms are called "silent stones." Silent stones do not interfere in gallbladder, liver, or pancreas function and do not require treatment.
Have Been Diagnosed With Gallbladder Disease?
Until just a few years ago, the most common treatment for symptomatic gallstones was a surgical procedure called cholecystectomy which required a large abdominal incision to remove the gallbladder. This was an extremely painful (based on my personal experience) and difficult to recover from operation that required at least five days in the hospital, and approximately six weeks for recovery.
Today laparoscopic cholecystectomy is most commonly performed. Laparoscopic cholecystectomy is usually performed in a day-surgery unit and requires only a tiny incision. My daughter's gallstones were treated laparoscopically, leaving her feeling well enough to continue her normal activities later that day. However, it should be noted that not all patients will recover almost instantaneously as my daughter did--the typical patient may need up to a week to recover before returning to normal activities.
Alternative treatments for gallstones include:
•Oral bile acid dissolution therapy.
•Contact solvent dissolution.
•Mechanical extraction through a catheter placed into the gallbladder either through the skin or through and endoscope.
•Fragmentation through shock-wave lithotripsy combined with bile acid dissolution.
Each of these alternative treatments leave the gallbladder in place. Because the gallbladder is not removed during these treatments many patients face a significant risk of recurrence.
Have Been Diagnosed With Gallbladder Disease?
People who may be at risk for developing gallstones may want to try modifying their diet to decrease their risk. The amount of dietary fiber consumed is an important therapy for gallstones that is often overlooked. Gallstones may be prevented by increasing consumption of both soluble and insoluble fiber which reduces the absorption of deoxycholic acid by producing a favorable shift in the triad of factors that control cholesterol's solubility in bile. Soluble fibers which are effective include guar gum and pectin, as well as other types of fiber (including oat bran, wheat bran, and soy fiber) which are found in many fruits and vegetables. The benefit of fiber is seen in the low incidence of gallstones in vegetarians.
Coffee drinking has been associated with a decreased risk of symptomatic gallstones, according to research conducted by the Harvard School of Public Health and published in the June 9, 1999 issue of the "Journal of the American Medical Association". The study found that men (over 46,000 men were studied) who drank two or three cups of coffee a day had a 40 percent lower risk of developing gallstones, while men who drank 4 or more cups of coffee a day decreased their risk by 45 percent. The study found no relation between gallstone prevention and tea, decaffeinated coffee, or caffeinated soft drinks.
Regular, vigorous, exercise may decrease the risk of gallstones. One study, reported by WebMD, found that men who performed endurance activities such as jogging, running, racquet sports, and brisk walking for 30 minutes five times a week, experienced a 34 percent reduction in risk for gallbladder disease. The amount of benefit derived from exercise was more dependent on intensity than type of exercise. Researchers theorize that exercise helps to normalize blood sugar and insulin levels which may contribute to gallstones, if abnormal.
There is also some research which suggests that taking nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen offers some protection against the formation of gallstones. However, one study found no difference in the risk of gallstones in over 400 chronic arthritis patients who regularly took NSAIDS.
Another option, approved by the FDA for obese patients, is a drug called Actigall®. This is the first drug approved for the prevention of gallstones; it has been used in carefully selected patients since 1988.
Have Been Diagnosed With Gallbladder Disease?
•Gallstones affect approximately one in ten Americans, and are associated with approximately 3,000 deaths annually.
•More than 800,000 hospitalizations each year are caused by gallstones that are large enough to cause significant pain.
•Over 500,000 people undergo surgery for gallstones annually.
•Obesity is one of the strongest risk factors for gallstones.
•Rapid weight loss diets significantly increase the risk for gallstones.
The normal function of the gallbladder is to store bile produced by the liver, and to aid in the digestion and absorption of fats in the duodenum (the first portion of the small intestine). Gallstones compose a solid formation of cholesterol and bile salts. However, research shows that approximately 80 to 90 percent of all gallstones are cholesterol gallstones which form when the liver begins secreting bile that is abnormally saturated with cholesterol. The excess cholesterol crystallizes and then forms stones which are stored in the gallbladder or the cystic duct. Gallstones can also form due to low levels of bile acids and bile lecithin.
Who Is At Risk For Gallstones?
When I was diagnosed with gallstones at 26, I was told that the typical gallstone patient was fair, fat, and forty. Today gallstones are seen in younger patients, perhaps due to the large amount of fast foods being consumed. My daughter went through five years of vomiting beginning at age 15, leading me to almost believe that she was bulimic, before she was diagnosed with gallstones at age 20. Risk factors which can lead to increased incidence of gallstones include the "Four Fs:" fat, female, fertile, and flatulent, as well as sickle cell disease (bilirubin), cirrhosis, Crohn's disease, diabetes, pancreatic disease, and hyperparathyroidism.
When the symptoms of gallstones occur they are often called an "attack" because they occur suddenly. The typical gallstone attack includes: •Steady, severe pain in the upper abdomen that increases rapidly and lasts from 30 minutes to several hours.
•Pain in the back between the shoulder blades.
•Pain under the right shoulder.
•Nausea or vomiting.
Gallstone attacks often follow fatty meals, and they may occur during the night. Although I was lucky not to have too much nausea and vomiting with my gallstones, one of my most vivid childhood memories is of my mother up at night, in the bathroom, vomiting.
Other symptoms of gallstones include:
•Abdominal bloating.
•Recurring intolerance of fatty foods.
•Colic.
•Belching.
•Gas.
•Indigestion.
The following symptoms are indication that you should seek immediate medical attention:
•Sweating.
•Chills.
•Low-grade fever.
•Yellowish color of the skin or whites of the eyes.
•Clay-colored stools.
Many people have gallstones with no symptoms, these people are called asymptomatic. Gallstones that cause no symptoms are called "silent stones." Silent stones do not interfere in gallbladder, liver, or pancreas function and do not require treatment.
Have Been Diagnosed With Gallbladder Disease?
Until just a few years ago, the most common treatment for symptomatic gallstones was a surgical procedure called cholecystectomy which required a large abdominal incision to remove the gallbladder. This was an extremely painful (based on my personal experience) and difficult to recover from operation that required at least five days in the hospital, and approximately six weeks for recovery.
Today laparoscopic cholecystectomy is most commonly performed. Laparoscopic cholecystectomy is usually performed in a day-surgery unit and requires only a tiny incision. My daughter's gallstones were treated laparoscopically, leaving her feeling well enough to continue her normal activities later that day. However, it should be noted that not all patients will recover almost instantaneously as my daughter did--the typical patient may need up to a week to recover before returning to normal activities.
Alternative treatments for gallstones include:
•Oral bile acid dissolution therapy.
•Contact solvent dissolution.
•Mechanical extraction through a catheter placed into the gallbladder either through the skin or through and endoscope.
•Fragmentation through shock-wave lithotripsy combined with bile acid dissolution.
Each of these alternative treatments leave the gallbladder in place. Because the gallbladder is not removed during these treatments many patients face a significant risk of recurrence.
Have Been Diagnosed With Gallbladder Disease?
People who may be at risk for developing gallstones may want to try modifying their diet to decrease their risk. The amount of dietary fiber consumed is an important therapy for gallstones that is often overlooked. Gallstones may be prevented by increasing consumption of both soluble and insoluble fiber which reduces the absorption of deoxycholic acid by producing a favorable shift in the triad of factors that control cholesterol's solubility in bile. Soluble fibers which are effective include guar gum and pectin, as well as other types of fiber (including oat bran, wheat bran, and soy fiber) which are found in many fruits and vegetables. The benefit of fiber is seen in the low incidence of gallstones in vegetarians.
Coffee drinking has been associated with a decreased risk of symptomatic gallstones, according to research conducted by the Harvard School of Public Health and published in the June 9, 1999 issue of the "Journal of the American Medical Association". The study found that men (over 46,000 men were studied) who drank two or three cups of coffee a day had a 40 percent lower risk of developing gallstones, while men who drank 4 or more cups of coffee a day decreased their risk by 45 percent. The study found no relation between gallstone prevention and tea, decaffeinated coffee, or caffeinated soft drinks.
Regular, vigorous, exercise may decrease the risk of gallstones. One study, reported by WebMD, found that men who performed endurance activities such as jogging, running, racquet sports, and brisk walking for 30 minutes five times a week, experienced a 34 percent reduction in risk for gallbladder disease. The amount of benefit derived from exercise was more dependent on intensity than type of exercise. Researchers theorize that exercise helps to normalize blood sugar and insulin levels which may contribute to gallstones, if abnormal.
There is also some research which suggests that taking nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen offers some protection against the formation of gallstones. However, one study found no difference in the risk of gallstones in over 400 chronic arthritis patients who regularly took NSAIDS.
Another option, approved by the FDA for obese patients, is a drug called Actigall®. This is the first drug approved for the prevention of gallstones; it has been used in carefully selected patients since 1988.
Have Been Diagnosed With Gallbladder Disease?
•Gallstones affect approximately one in ten Americans, and are associated with approximately 3,000 deaths annually.
•More than 800,000 hospitalizations each year are caused by gallstones that are large enough to cause significant pain.
•Over 500,000 people undergo surgery for gallstones annually.
•Obesity is one of the strongest risk factors for gallstones.
•Rapid weight loss diets significantly increase the risk for gallstones.
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