Gallstones are pebble-like substances that form in the gallbladder, a small organ located under the liver, which helps with digestion. These stones develop from cholesterol and pigments in bile forming hard particles. You may have one or more gallstones and not know about them. When symptoms do occur, you may have stomach and back pain, feel nauseous, and you may vomit. If you suspect you have symptoms of gallstones, it is important to make your doctor aware of these symptoms to prevent more serious problems from developing.
Some possible causes of gallstones include:
• Excessive bilirubin in the bile.
• Excessive cholesterol in the bile.
• Blockage in the gallbladder that prevents proper emptying.
• Low concentration in the bile of substances called bile salts.
Who is at risk for Gallstones?
Women are at a greater risk for developing gallstone disease than men, because the female hormone estrogen increases cholesterol in the bile. With age, the development of gallstones decreases somewhat in women and increases in men. Under the age of 40, women are diagnosed with gallstones almost three times more often than men, but after the age of 60, they have only a slightly higher incidence compared to men. The drop in levels of estrogen hormone at menopause may be one reason.
Obesity is another risk factor that increases the incidence of gallstones, especially in women, because fat tissue influences the amount of estrogen produced in the body. Very low-calorie diets interfere with bile production, and therefore, rapid weight loss or weight-loss surgery (also known as bariatric surgery or lap band surgery) increases the risk of gallstone disease by causing more crystallization of cholesterol. In fact, gallstones are so common after weight-loss surgery that patients are often advised to have their gallbladders removed at the time of the weight-loss surgery itself.
Finally, gallstones are more likely to occur in people with diabetes, high triglycerides (a type of cholesterol), or any other condition that decreases contractions of the gallbladder or motility of the intestine such as a spinal cord injury.
What increases the risk of Gallstones?
The chances of gallstone formation, especially stones that cause symptoms, are higher in:
• Females: Women are twice as likely as males to develop gallstones.
• People older than 55.
• People belonging to ethnic groups like Native Americans or Mexican-Americans.
• People with a family history of gallstones.
• People who have had organ or bone marrow transplants.
• People with diabetes.
• People with cirrhosis of the liver.
Other factors that increase the risk of gallstones:
• Quick weight loss by dieting and then regaining the weight back again.
• Estrogen supplements (after menopause) or high-dose birth control pills.
• Lack of exercise.
• Fasting (not eating for a period of time).
What decreases the risk of Gallstones?
• Eating a vegetarian diet may reduce the risk of developing gallstones. Compared to people who eat meat, vegetarians have a significantly lower risk of developing gallstones.
• According to many experts, a diet low in fat and high in fruits and vegetables, including plenty of dietary fiber, helps protect people from developing gallstones.
• Controlling your body weight and keeping yourself from becoming overweight or obese may also help prevent the formation of gallstones. However, crash dieting and rapid weight loss increase the risk of development of gallstones.
• A study has indicated that exercise can reduce the risk of developing gallstones.
It is fortunate that surgical treatment is available for gallstone disease and has a high success rate. It is also fortunate that the gallbladder is not a vital organ and we can live without it. While gallstones are not entirely preventable, there are some risk factors that can be modified to decrease the likelihood of developing gallstones. Age, gender, and ethnicity cannot be altered, but it is possible that modifying other risk factors will reduce your risk of developing gallstones.