More than 25 million men and women in the United States are affected by gallbladder disease, an umbrella term that includes: Gallstones Hardened deposits of digestive fluid that can form in your gallbladder. They can range in size from as small as a grain of sand to as large as a golf ball. Gallstones can be painful and cause nausea and vomiting, but often they are asymptomatic and don’t require surgery. Cholecystitis This inflammation of the gallbladder is often caused by gallstones blocking the tube that leads out of your gallbladder. Other causes include bile duct problems, tumors, serious illness, and certain infections. Cholecystitis can lead to life-threatening complications if left untreated. Gallbladder cancer A form of cancer that starts in the gallbladder with a group of cells that grow out of control. About 9 out of 10 gallbladder cancers are adenocarcinomas — a cancer that starts in cells with gland-like properties that line many internal and external surfaces of the body. Gallbladder disease can affect anyone, but some people are more vulnerable than others. You are most at risk of having gallbladder problems if you:
Are a womanAre older than 60Have a family history of gallbladder problemsAre overweight or obeseHave diabetesTake certain medicationsAre Native American or Mexican American
Risk Factors for Gallbladder Problems Out of Your Control
Gender In all populations of the world, women are twice as likely as men to develop gallstones, according to research published in April 2012 in the journal Gut and Liver. Pregnant women and those taking hormone replacement therapy are more at risk for gallstones because of higher estrogen levels. Too much estrogen can increase cholesterol in the bile and lessen gallbladder movement, increasing the risk of gallstones. The sex difference narrows with increasing age, but is still prevalent. Genes According to research published in 2013 in Advances in Clinical Chemistry, the tendency to develop gallstones and gallbladder disease often runs in families, indicating there may be a genetic link. Also, a mutation in a gene that controls the movement of cholesterol from the liver to the bile duct may increase a person’s risk of gallstones. Defects in certain proteins may increase the risk of gallbladder disease in some people. Age Gallstones are 4 to 10 times more frequent in the older population, especially in people over 60. That’s because as you age your body tends to release more cholesterol into bile, which makes it more likely that stones will form in the gallbladder. Ethnicity Studies have shown a clear association between race and risk of gallbladder problems that cannot be completely explained by environmental factors. Risk varies widely from extremely low (less than 5 percent) in Asian and African populations, to intermediate (10 to 30 percent) in European and Northern American populations, to extremely high (30 to 70 percent) in Native American populations. Native Americans and Mexican Americans are more likely to develop gallstones than other ethnic groups, probably as a result of dietary and genetic factors.
Risk Factors for Gallbladder Problems You Can Change
Although there are a number of things out of your control when it comes to your risk of developing gallbladder problems, you can reduce your risk by maintaining a healthy weight, watching your diet, and paying close attention to how your body reacts to certain medications. People who are even moderately overweight or obese are at increased risk of gallbladder problems. When you’re overweight, the liver produces too much cholesterol, overloading the bile ducts and increasing the risk for gallstones. Women especially should watch their weight, because studies have found that a lithogenic risk of obesity is strongest in young women; this means they are more likely to develop calculi (buildup of mineral stones in an organ). Rapid weight loss as a result of fasting or crash diets, and weight cycling — losing and then regaining weight — can increase cholesterol production in the liver, increasing a person’s risk of gallstones. In fasting associated with severely fat-restricted diets, gallbladder contraction is reduced, which can also lead to gallstone formation. But research shows that a shorter overnight fast is protective against gallstones in both men and women. Diet plays a major role in gallbladder disease because diet influences your weight. People who are overweight and eat a high-fat, high-cholesterol, low-fiber diet are at increased risk of developing gallstones. Exposure to the Western diet (increased intake of fat, refined carbohydrates, and limited fiber content) is a high risk for developing gallstones. And too much heme iron — iron found in meat and seafood — may increase gallstone formation in men. Coffee consumption seems to lower the risk of gallstone formation, by enhancing gallbladder motility, inhibiting gallbladder fluid absorption, and decreasing cholesterol crystallization in the bile, according to research published in the July–December 2013 issue of the Nigerian Journal of Surgery. Certain cholesterol-lowering medications, such as Lopid (gemfibrozil) and Tricor (fenofibrate), can increase a person’s risk of gallstones. While these drugs successfully decrease blood cholesterol, they increase the amount of cholesterol in the bile, and thus the chance for gallstones to develop. Other drugs that may increase the risk of gallstones include Sandostatin (octreotide) and a group of diuretics known as thiazides. Octreotide is used to treat certain hormonal disorders and severe diarrhea caused by cancer tumors. Prolonged use of proton pump inhibitors has been shown to decrease gallbladder function, potentially leading to gallstone formation. If you are concerned that a medication you are taking may increase your risk of gallbladder disease, talk to your doctor. There may be another medication that will do the same thing without increasing your risk for gallbladder problems.
Other Risk Factors for Gallbladder Problems
In addition to genetic and lifestyle factors, certain medical conditions or surgical procedures can also increase your likelihood of developing gallbladder problems. These include: Diabetes and metabolic syndrome People with diabetes generally have high levels of fatty acids, which may increase the risk of gallstones. Additionally, gallbladder function is impaired in the presence of diabetic neuropathy, and regulation of hyperglycemia with insulin seems to raise the lithogenic index (risk of developing mineral deposits in the gallbladder that can turn into gallstones). People with diabetes are at risk for developing a type of gallbladder disease called acalculous cholecystitis, meaning gallbladder disease without gallstones. Crohn’s disease and other medical conditions People with Crohn’s disease, an inflammatory bowel disorder, are also at increased risk of gallbladder disease. There are a few reasons for this, but one of the main ones is that if bile salts are not reabsorbed in the ileum (the end of the small intestine), they pass out of the body. This loss of bile salts means that the liver has fewer bile salts to put into new bile. The new bile becomes overloaded with cholesterol, which can in turn result in gallstones. In addition, cirrhosis of the liver and certain blood disorders, such as sickle cell anemia, also increase a person’s risk of pigment gallstones, which are gallstones made up of bilirubin instead of cholesterol. Low melatonin levels associated with diabetes could contribute to gallstones as well because melatonin inhibits cholesterol secretion from the gallbladder; melatonin is also an antioxidant that reduces oxidative stress to the gallbladder. Surgery People who undergo bariatric surgery to lose weight are at increased risk for gallstones. Rapid weight loss in general is a risk factor. According to Bariatric Innovations of Atlanta, gallstone formation can be found in as many as 35 percent of weight loss surgery patients. Organ transplant surgery may also increase the risk of gallstones, and it is not uncommon for some doctors to recommend that their patients have their gallbladder removed before they undergo an organ transplant.
Ways to Prevent Gallbladder Problems
Many factors may increase your risk of developing gallbladder problems. While you can’t do much about your genes or ethnicity, you can watch your weight and eat healthfully: Focus on whole grains, fruits and vegetables, fish, and lean meats. Maintaining appropriate portion size and limiting processed foods and added sugars is also essential to a healthy diet. A study published in July 2016 in the journal Preventive Medicine found that vegetable protein is associated with lower gallbladder disease risk. Additional reporting by Jamie Putman.
