Gallbladder Disease

The gallbladder is a sac located under the liver. It stores and concentrates bile produced in the liver. Bile aids in the digestion of fats, and is released from the gallbladder into the upper small intestine (duodenum) in response to food, especially fats. In the intestine, bile emulsifies fat, which prepares it for digestion, and then carries it into the cells so it can continue to be metabolized. The function of the gallbladder can be slowed or stopped by disease of this organ. Dr. Hoffman states “Gallbladder disease is a modern illness, with an estimated twenty million Americans have gallbladder disease” (1). With so many Americans affected by this disease let’s take a look at the contributing risk factors associated with gallbladder disease.
The cause and contributing risk factors for the development of gallbladder disease are as follows by Dr. Hoffman (1):
• Heredity. Gallstones occur slightly more frequently in Mexican Americans and Native Americans but also common in people of northern European stock.
• Age. Gallbladder disease often strikes people over sixty years of age.
• Gender. In medical school, the “five F’s” help doctors to remember the usual patient with gallbladder disease: fair, fat, forty, fertile, and female. Sexist as it sounds, it describes the group most frequently affected by gallbladder disease: overweight middle-aged white women with a history of several pregnancies. Excess estrogen may be implicated, since hormone replacement after menopause increases the likelihood of stones.
• Diet. The propensity of Western diet can predispose one to gallbladder disease was commemorated by journalists during the Persian Gulf War—the prevalence of gallbladder disease among Saudis had gone up 600 percent since the 1940s, when they began enjoying more and more Western foods! Most people know that there is an established link between fat intake and gallbladder disease, but many don’t realize that there is also a significant correlation with high sugar intake as well.
• Obesity. In comparison with people of normal weight, the bile of obese people is supersaturated with cholesterol, predisposing them to the development of gallbladder illness.
• Slow intestinal transit. Medical professionals have long known that constipation is common in patients who have gallbladder disease. Studies confirm that slow intestinal transit contributes to the formation of gallstones in women of normal weight.
Of all the factors listed above as a contributing factor, obesity is the biggest factor for people. Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated. Let’s continue the journey of gallbladder disease by examining the sign/symptoms and or complication from having this disease. Types of gallbladder disease include:
• Cholecystitis (inflammation of the gallbladder)
• Cholelithiasis (gallstones)
The most serious complication of acute cholecystitis is infection, which develops in about 20% of cases. It is extremely dangerous and life threatening if it spreads to other parts of the body (a condition called septicemia), and surgery is often required. Symptoms include fever, rapid heartbeat, fast breathing, and confusion (“Gallbladder and gallstones” 4). Cholelithiasis, also known as gallstones, is a mixture of cholesterol and bile salt that act like a natural material to break down fats in the food we eat. Researchers believe there are three main conditions which cause gallstones to form according to Tracee Cornforth, “the bile becomes supersaturated with cholesterol, causing the bile to contain more cholesterol than the bile salts can dissolve. Second, an imbalance of proteins or other substances in the bile causes the cholesterol to start to crystallize. Third, the gallbladder does not contract enough to empty its bile regularly (Cornforth 1). The treatment for both inflammations of the gallbladder and gallstones depends on the patient. A person can have gallstones without any symptoms. However, if the stones are large, they can block the duct that leads from the gallbladder. This can cause pain and require treatment if they do not move away, causing only occasional pain. Continuous blockage of the duct, however, can be life threatening and requires surgical removal of the gallbladder. Another form of treatment includes drugs that can dissolve the stones but this treatment can take up to 2yrs for the stone to dissolve. In addition, expectant management which is also called the “wait and see” method if the patient has no symptoms.
Dr. Hoffman states this is a degenerative disease that is clearly related to diet (1). A person’s fat and cholesterol intake determines how much our gallbladder works to emulsify the fats in our body. There are significant health benefits to be gained from losing excess pounds. You can monitor, measure, and evaluate the desired changes by watching your Body Mass Index and regular visits to the doctor.
The recommendation I would share to other health professionals about gallbladder disease is patients diet plays a big part in a healthy gallbladder function. Maintaining a healthy diet that is low in fat and cholesterol, moderate in calories and high in fiber is a good way to keep a healthy weight and lower the risk the for gallstones. Foods that should be included in a person diet: fresh fruit and vegetables, whole grains (whole-wheat bread, brown rice, oats, bran cereal), lean meat, poultry, and fish, low-fat dairy products. Changing your diet will not completely get rid of gallstones if they are already there, but limiting the amount of saturated fats and cholesterol-heavy foods would help ease the symptoms. The foods that should be avoided are: fried foods, highly processed foods (doughnuts, pie, and cookies), whole-milk dairy products (cheese, ice cream, and butter), and fatty red meats. Although a person diet does not directly cause gallbladder problems, but watching what you eat and keeping a healthy weight might prevent problems from developing. It is important as a health care professional that we make sure we are educating our patients on the importance of healthy lifestyle and weight to prevent many problems from forming. Works Cited

Cornforth, Tracee. "Dieting and Gallstones." Women's Health Issues - Women's Health Questions and Answers - Women's Sexual Health. 28 Nov. 2003. 20 Mar. 2011 .

Hoffman, M.D., CNS, Ronald. "Gallbladder disease." Dr. Ronald Hoffman - The Hoffman Center - WOR Radio's Health Talk. 20 Mar. 2011 .

Http://www.euronet.nl/~jonkr/, Ron Jonk-. "Gallbladder disease." University of Maryland Medical Center | Home. 21 Mar. 2011 .

Http://www.euronet.nl/~jonkr/, Ron Jonk-. "Gallstones and gallbladder disease - Symptoms." University of Maryland Medical Center | Home. 21 Mar. 2011 .
Watson, Stephanie. "Gallbladder Diet: Foods for Gallbladder Problems." WebMD - Better information. Better health. 17 Mar. 2009. 20 Mar. 2011 .