Growing Obesity Epidemic Leads to Greater Risk of Gallstones

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Gallstones are one of the many serious health risks related to the growing global epidemic of obesity. Experts estimate that 20-25 million adults in the United States have them, with women more susceptible than men. Gallstone disease is a leading cause of gastrointestinal tract illness and inpatient admission in western countries.

Gallstones are hard, crystal-like clumps that form in the gallbladder, an organ located below the liver in the right upper abdomen. About 80% are composed primarily of hardened cholesterol; however, having gallstones is not directly related to having high blood cholesterol. The remainder of stones are called pigment stones and are caused by having too much bilirubin in the bile that helps the body digest fats.

Gallstones are twice as common in women than in men because estrogen causes more cholesterol to be excreted in the bile. Ethnic groups such as Native Americans and Mexican Americans are more likely to experience gallstone disease.

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Obesity, cardiovascular disease, and diabetes are also strong risk factors. People who are overweight or obese tend to have increased levels of cholesterol and reduced amounts of bile salts in their bile, causing stones to form. Obesity also appears to decrease gallbladder emptying. Those with diabetes generally have higher levels of triglycerides which increase the risk of gallstone formation.

Many people with gallstones never have symptoms. However, if a large stone blocks either the cystic duct or common bile duct, there may be a cramping pain in the middle to right upper abdomen. Other symptoms may include fever, jaundice, feelings of abdominal fullness, clay-colored stools, and nausea and vomiting.

Achieving a healthy weight is one way to reduce the risk of forming gallstones, however, weight loss should be achieved through exercise and a low-calorie, low-fat diet consisting of plenty of fiber, fruits, and vegetables. Rapid weight loss through fasting, very low calorie diets or weight loss surgery increases the risk of forming gallstones and causing silent gallstones to become symptomatic.

Although gallstones can form in the absence of hyperlipidemia (high blood cholesterol), a recent JAMA study found that the use of cholesterol-lowering statin drugs for more than a year was associated with the reduced risk of having gallstones that required surgery. Statins appear to decrease hepatic (liver) cholesterol synthesis, thereby reducing cholesterol concentration in the bile.

Notify your doctor if you think you are experiencing a gallbladder attack with symptoms such as prolonged pain (more than 5 hours), nausea and vomiting, fever or chills, or jaundice. Even if the pain subsides as the stone begins to move through the intestine, the gallbladder can become infected and a rupture may occur if a blockage remains.

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Comments

Thank you for a very clear article about two increasingly serious problems in our society gallstones and obesity. Muryal