Risk Factors and Treatment for Gallstones

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Causes of gallstones is usually the result of too much cholesterol or bilirubin in the bile. Risk factors for developing gallstones can be a combination of factors, including her heredity, body chemistry, body type, gender, and maybe even an individual's diet.

Risk Factors

Risk factors for developing gallstones include:

  • Obesity. Obesity is a major risk factor for gallstones, especially in women. Clinical studies have shown that being even moderately overweight can increase the risk for developing gallstones.
  • Rapid weight loss. When an individual goes on a crash diet or losses weight rapidly for another reason, the body metabolizes fat at a faster rate. As a result, the liver secretes more cholesterol into the bile. The increased level of cholesterol can increase the risk of developing gallstones.
  • Estrogen. Excess estrogen from pregnancy, hormone replacement therapy, or birth control pills appears to increase cholesterol levels in bile and decrease gallbladder movement, both of which can lead to gallstones.
  • Ethnicity. Studies have shown that American Indians secrete higher levels of cholesterol in their bile, putting them at a higher risk of developing gallstones. Studies have shown that the majority of American Indian men have gallstones by age 60, and 70 percent of women have gallstones by age 30.
  • Gender. Women are twice as likely to develop gallstones as men.
  • Age. The chances of developing gallstones increases with age. People over age 60 are more likely to develop gallstones than younger people.
  • Cholesterol-lowering drugs. Drugs that lower cholesterol levels in blood actually increase the amount of cholesterol secreted in bile. This in turn can increase the risk of gallstones.
  • Diabetes. People with diabetes generally have high levels of fatty acids called triglycerides. These fatty acids increase the risk of gallstones.

    Treatment Options

    Treatment of gallstones depends partly on whether you are experiencing symptoms or not. If symptoms (especially severe pain) are present, surgical removal of the gallbladder is the most common treatment. If you have no symptoms, you and your doctor may decide that no treatment is needed.

    Surgery for Gallstones

    An estimated 500,000 Americans have gallbladder surgery each year. I become one of them when my gallbladder was removed in February 2008. This surgery is called a cholecystectomy.

    The most common operation for gallbladder removal is called laparoscopic cholecystectomy. The surgeon makes three or four tiny incisions in the abdomen, and then inserts surgical instruments and a miniature video camera into the abdomen. The surgeon uses the camera to see what he is doing and uses the instruments to remove the gallbladder and gallstones. The surgeon will also inspect the bile ducts and inject a dye to check for any stones or blockages.

    If infection or scarring from other surgeries is found, a surgeon may perform an open surgery instead of the laparoscopic surgery.

    "Open" surgeries involve the surgeon making a 5- to 8-inch incision in the abdomen to remove the gallbladder. Sometimes a surgeon knows before the surgery that an open surgery will be necessary and will plan this with the patient. However, a surgeon may encounter a complication after a laparoscopic surgery has begun, and will find it necessary to switch to doing an open surgery instead.

    Patients experience less pain, fewer complications, and shorter recovery time with the laparoscopic option than they do after an open surgery. With open surgery, there is more pain, the risk of more complications, and longer hospital stay and recovery time.

    Sources:
    "Common Gastrointestinal Problems - Gallstones." American College of Gastroenterology. 9 Sep 2008

    "Gallstones." American College of Gastroenterology. 9 Sep 2008

    "Gallstones." NIH Publication No. 07–2897 July 2007. National Digestive Diseases Information Clearinghouse (NDDIC). 9 Sep 2008

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