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Gallstones - Symptoms - Treatments - Prevention
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Like many people, you may have gallstones and not know it. In fact, gallstones — solid deposits of cholesterol or calcium salts that form in your gallbladder or nearby bile ducts — often cause no symptoms and require no treatment. But up to about one-fifth of people with gallstones will have a gallbladder attack that can cause symptoms such as nausea and an intense, steady ache in their upper-middle or upper-right abdomen. In some cases the pain can be severe.

Risk factors

Gallstones tend to run in families. Other factors that may increase your risk include:

  • Sex. Women between the ages of 20 and 60 are more than twice as likely as men are to have gallstones. That's because the female hormone estrogen causes more cholesterol to be excreted in bile. Pregnancy, which causes estrogen levels to rise, also increases the risk. In addition, birth control pills and hormone replacement therapy (HRT) both increase bile cholesterol levels and decrease gallbladder emptying. If you take these medications and are concerned about gallstones, talk to your doctor. HRT has other potential side effects as well. Taking HRT as a combination therapy — estrogen plus progestin — can result in serious health risks. Work with your doctor to evaluate the options and decide what's best for you.

  • Body weight. As your body mass index (BMI) — a method of estimating your percentage of body fat using your height and weight — increases, so does your risk of developing gallstones. Being even moderately overweight increases cholesterol in your bile. It also decreases bile salts and reduces the frequency with which your gallbladder contracts and empties.

  • Diet. A diet high in fat and sugar combined with a sedentary lifestyle increases your risk of gallstones. In addition, low-calorie, rapid-weight-loss diets tend to disrupt your bile chemistry and may cause your gallbladder to contract less often. This makes it more likely you'll develop gallstones. In fact, losing more than 3 pounds a week may increase your risk of developing gallstones when compared with losing weight more gradually. People who undergo gastrointestinal surgery to lose weight rapidly, also called bariatric surgery, are at increased risk of gallstones. As many as one-third of people who have bariatric surgery may develop symptomatic gallstones a few months after surgery.

  • Age. Your chance of developing gallstones increases with age. People older than 60 years of age are more likely to have gallstones than are those who are younger. But this doesn't mean that the gallstones don't start forming before age 60. Gallstones are just more likely to be symptomatic after many years of development or they are found incidentally.

  • Ethnicity. Indians have the highest incidence of gallstones. Mexican-Americans also are at increased risk.

When to seek medical advice

Call your doctor if you develop a sudden, intense pain in your abdomen, especially if you also have nausea and vomiting. If you develop one or more symptoms of bile duct obstruction — abdominal pain, yellowing of your skin and the whites of your eyes, dark urine, and a high fever with chills — seek emergency care.

Gallstones > 1 > 2 > 3 > 4

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