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Obese Kids and Gallstones: What Parents Should Know

Obese kids and gallstones

In addition to heart disease and diabetes, parents of overweight or obese kids can now add the increased risk of gallstones to the list of serious health conditions associated with their child's weight. Results of new research from Kaiser Permanente, USA, could be a wakeup call for both parents and pediatricians. Here's what parents should know.

Parents should be aware of gallstone risk

Gallstones and gallstone disease (cholelithiasis) traditionally have not been seen much among children and teenagers, but as young people grow in girth, so does their risk of developing gallstones. Since about one-third of kids and adolescents in the United States are overweight or obese--triple the rate seen in 1963--parents and doctors could have a significant problem on their hands.

The Kaiser Permanente team, under the leadership of Corinna Koebnick, PhD, evaluated data from more than 510,000 kids aged 10 to 19 years who represented a wide range of ethnic and racial groups. Using normal weight kids and teens as the comparison group, they found that:

  • Extremely obese young people had six times the risk of developing gallstones
  • Moderately obese young people had four times the risk
  • Overweight young people had twice the risk
  • Hispanic kids and teens seem to have the greatest risk
  • Females appear to be at greater risk than boys. Extremely obese and obese girls have a 6 to 8 times higher risk, respectively. Extremely obese males have 3 times the risk, while obese males have twice the risk

According to Koebnick, given the rise in childhood obesity, "pediatricians can expect to diagnose and treat an increasing number of children affected by gallstone disease," and they also need to "identify other factors that increase risk as well."
Among adults, those risk factors have typically been considered to be the following:

  • Female
  • Age 60 or older
  • Being Hispanic or Native American
  • Overweight or obesity
  • Pregnancy
  • Eating a diet high in fat and/or cholesterol
  • Eating a diet low in fiber
  • Diabetes
  • Family history of gallstones
  • Use of some cholesterol-lowering drugs

As you can see, some of these risk factors can be applied to kids and teens.

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Other reports on kids and gallstones
The Kaiser Permanente study is not the only recent report on gallstones in kids. Swedish researchers just published their findings in Seminars in Pediatric Surgery, noting that "Gallstone disease in children is evolving" and that "the frequency for surgery has increased greatly." They note that this is occurring in part because of "increased awareness of emerging comorbidities, such as childhood obesity."

A report in a recent issue of Pediatric Emergency Care on the complications of cholelithiasis in children and teenagers pointed out that "In recent years, gallbladder disease...has been on the rise among infants and children." They noted that healthcare providers (and one should add parents as well) "need to be aware of this underappreciated problem."

More on gallstones
Parents should know the signs and symptoms of gallstones, which may include the following. Pain can last from several minutes to several hours.

  • Back pain between the shoulder blades
  • Pain in the right shoulder
  • Pain immediately below the ribs on the right side of the body
  • Sweating
  • High fever and chills
  • Vomiting
  • Yellowing of the whites of the eyes, skin, and tongue

George Longstreth, MD, senior study author, noted that "Since obesity is so common, pediatricians must learn to recognize the characteristic symptoms of gallstones." Parents who have overweight or obese kids also need to know about the symptoms and risk of gallstones that their children face.

American Heart Association
Koebnick C et al. Pediatric obesity and gallstone disease: results from a cross-sectional study of over 510,000 youth. Journal of Pediatric Gastroenterology & Nutrition 2012. DOI:10.1097/MPG.0b013e31824d256f
Poffenberger CM et al. Cholelithiasis and its complications in children and adolescents: update and case discussion. Pediatric Emergency Care 2012 Jan; 28(1): 68-76
Svensson J, Makin E. Gallstone disease in children. Seminars in Pediatric Surgery 2012 Aug; 21(3): 255-65

Image: Morguefile