The Inside Line on Gallstones

By: Red Hot Mamas

Published: May 26, 2010

You may have gallstones and not even know it! You can spend your entire life with silent stones (those without symptoms) and never have to worry about them. Gallstones can be smaller than a grain of sand or as large as a golf ball. They form when the cholesterol and other components in your bile build up and form hard crystals (or stones). Most of them don’t cause any problems but if they block a duct, they can be excruciatingly painful.

Many people with problem gallstones can experience a gallstone attack which can be severely painful. Gallstone attacks come suddenly and last for hours to days and can bring steady pain in the abdomen, back and under the right shoulder. The pain is sometimes accompanied by fever, vomiting or sweating. Problem gallstones can also cause symptoms including yellowish coloring of the skin or whites of the eyes and/or clay-colored stool. If you experience any of these symptoms, you should see a doctor immediately, especially if you have sudden, bad pain in your abdomen or chest.

Women are at increased risk for gallstones. Between the ages of 20 and 60 years, women are three times more likely to develop gallstones than men. Twenty percent of American women have them by the age of 60. The female hormones progesterone and estrogen tends to relax the gallbladder creating a slower flow of mile which makes it more likely that gallstones will form. A woman’s risk of gallstones increases with obesity, pregnancy, family history of gallstones on the mother’s side, ethnicity (Pima Indians, Scandinavians), Crohn’s Disease and hormone use. Ovarian hormones (oral contraceptives and menopausal hormone therapy) increase a certain type of cholesterol that forms gallstones. If you are considering menopausal hormone therapy, discuss your history of gallstones or gallbladder disease with your doctor.

Is there anything you can do to avoid gallstones? If you are at increased risk for gallstones, you may want to think about your diet. Keep eating your fiber (and maybe even increase your intake)! Fiber benefits certain factors controlling the solubility of cholesterol in bile. More fruits, veggies, oat bran, wheat bran and soy fiber can help prevent gallstones. Benefits are seen in the low incidence of gallstones in vegetarians who have an increased their fiber intake. In addition, coffee drinking has been associated with decreased risk of gallstones. In a recent Harvard School of Public Health study, researchers found that men who drank two to three cups of coffee a day had a 40% lower risk of developing gallstones, while men who drank 4 or more cups of coffee a day decreased their risk by 45%. Maybe a little coffee isn’t so bad for us after all!

Exercising regularly and vigorously can decrease your risk of gallstones as well. A WebMD study 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% reduction in risk for gallbladder disease. The theory is that exercise helps normalize blood sugar and insulin levels which may contribute to gallstones, if abnormal. So get moving!

A lot of gallstones are found during tests for other health conditions, but if your doctor suspects gallstones, they will probably order specific imaging tests so they can take a more detailed look at what is going on. About 80% of people with gallstones have no symptoms so tests are really only needed when you experience symptoms.

Sometimes a simple ultrasound will detect gallstones. If not, a gallbladder exam may give more detail. The gallbladder scan involves injecting a dye into a vein in your arm, followed by a special X-ray so they can see the dye moving through your body. Other tests may also be performed, including a CT scan, HIDA scan, ERCP or blood tests. An accurate diagnosis is important because gallstone symptoms can be similar to those of other serious conditions (a heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis and hepatitis).

Most gallstone treatments have better outcomes if started early. If you don’t have any symptoms, you may not need treatment. If your doctor discusses treatment options, also ask about side effects of these treatments. Sometimes eating more frequent, small meals is helpful. Depending on test results and your degree and frequency of pain, your doctor may recommend removing your gallbladder (a nonessential organ). More than 500,000 people undergo surgery for gallstones annually. Almost all surgery to remove the gallbladder is performed with laparoscopy. A tiny incision is made in the abdomen and a tiny laparoscope and miniature video camera are inserted. The surgeon removes the cystic duct and removes the gallbladder through a single, small incision. Recovery is quick – usually only one night in the hospital and you are back to your normal self after a few days of recovery at home. Removing the gall bladder may cause diarrhea due to bile draining into the digestive tract.

Nonsurgical approaches are available but are usually reserved for elderly patients or those too frail for surgery. The downside of non-surgical approaches is that gallstones usually show up again (in about half of all patients treated).

You can reduce your chances of developing gallstones by keeping to a healthy weight and sticking to a low cholesterol diet.

The Bottom Line on Gallstones

You should see your doctor if you experience any of these symptoms:

• Upper abdominal pain (often on right side)
• Nausea and vomiting
• Yellowing of the skin or whites of the eyes
• Pale stools
• Talk to your doctor about your risk factors and treatment options

References

Cornfort, Tracee. “Real Women Talk About Gallstones.” Women’s Health. About.com, 19 07 2009. Web. 16 Mar 2010. website.

“Gallstones.” Digestive Diseases. National Digestive Diseases Information Clearinghouse (NDDIC), 07 2007 . Web. 16 Mar 2010. website.

“Gallstones.” The American College of Gastroenterology, n.d. Web. 16 Mar 2010. website.

“Gallstones – Topic Overview.” Digestive Disorders Health Center. WebMD, 22 07 2009. Web. 16 Mar 2010.website.

Simpson, Nicole, Tommy Yen, and Ahmed Aijaz. “Gallstones and Complications: Detection and Treatment.” Nutrition. The Doctor Will See You Now, 03 2010. Web. 16 Mar 2010. website.