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Cut
your risk of getting gallstones
February 22, 2007
Suzanne Havala Hobbs
My
column on kidney stones earlier this month prompted questions
from readers about another common problem – gallstones.
Gallstones affect about one in ten Americans, and the risk
increases if you are overweight, over 60, Native American,
Mexican American, female, pregnant, or on birth control pills
or hormone replacement therapy. You’re also at greater
risk if you skip meals, go for long periods without eating,
or lose weight rapidly.
A lot of us have them, but exactly what are gallstones?
Most gallstones are beads of hardened cholesterol, often irregularly
shaped, formed from bile, a greenish brown fluid produced
in the gallbladder. Under ordinary circumstances, when you
eat a meal that contains fat, the gallbladder responds by
contracting and squeezing bile through a tube (the bile duct)
into the small intestine. In the small intestine, bile helps
your body digest fat.
Various conditions can cause cholesterol in bile to crystallize
and form stones. These stones – which can range in size
from a small speck to a ping pong ball – can obstruct
the bile duct, preventing bile from passing into the small
intestine. If that happens, intense abdominal pain may result.
That’s a gallbladder attack. They often happen after
rich, fatty meals.
A gallbladder attack can last anywhere from 15-30 minutes
to several hours. Subsequent attacks come weeks or even years
apart. Some gallstone symptoms – chronic indigestion,
nausea, vomiting, gas, bloating, and belching – can
also mimic other gastrointestinal problems, such as ulcers
and gastric reflux.
Complications of gallstones can be serious and even fatal,
and surgery to remove the gallbladder is the most common treatment.
But gallstones can also be present without causing any symptoms
or problems at all, and treatment is typically not needed
in those cases.
So how can you prevent gallstones from forming in the first
place? There’s no surefire way, but you can take steps
to lower your risk:
* Control your weight. Even moderate obesity increases the
risk of gallstones. Extra pounds results in a greater concentration
of cholesterol in the bile and reduces the ability of the
gallbladder to empty, according to the National Institute
of Diabetes and Digestive and Kidney Diseases (see http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/index.htm).
* Avoid rapid weight loss. Gradual weight loss – not
more than 2-3 pounds per week – is safest. Fad diets
and very low calorie diets force the body to burn fat stores
relatively quickly. That stimulates the liver to produce more
cholesterol and send more into the bile, increasing the risk
of stone formation. Fasting can have a similar result –
it decreases gallbladder activity and can permit cholesterol
to build up and form stones.
* Exercise and eat well. Regular, vigorous physical activity
– in conjunction with a healthful diet – is critical
for weight control. Diets rich in fiber from fruits, vegetables,
whole grains and beans are filling and relatively low in calories.
They’re also low in bad fats and cholesterol. Cut the
meat and fatty dairy products to a minimum. It should come
as no surprise that vegetarians have a rate of gallstones
much lower than that of nonvegetarians.
By now, you’re probably also getting used to another
common conclusion to these columns: Dietary recommendations
for the prevention of gallstones are the same as recommendations
for the prevention of most other chronic diseases and conditions.
The science may be complex, but the prescription is simple.
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