No woman immune to gall stones
If you’ve never felt the relentless, knife-like pain of an errant gallstone, consider yourself fortunate. The pain caused by a gallstone seems to originate under the ribs in your upper right quadrant, but boars through to the back and is not relieved by any amount of rocking, groaning or endless trips to the bathroom.
But take heed. If the door of your public restroom preference sports the international symbol wearing a skirt, know that you are twice as likely to develop gallstones as men.
“Fat, female and over 40” was the medical community’s mantra until studies showed that even younger, normal weight women are not immune from developing the hard, crystal-like chunks.
Why do gallstones form?
Obesity is certainly a risk factor for gallstones, but so is yo-yo dieting. U.S. researchers discovered that episodes of weight cycling, during which a woman loses a significant amount of weight – at least 10 pounds – then regains it in a short period of time can increase her chance of developing gallstones by as much as 70 percent. Forty-seven thousand women took part in an ongoing Nurses’ Health Study, which produced these figures.
Your ethnicity may also be a factor. According to statistics published in the April 1996 issue of the “Harvard Women’s Health Watch,” Native American women have an 80 percent lifetime chance of developing gallstones. It has something to do with their predisposition to secrete high levels of cholesterol into bile, which is secreted by the liver and stored in the gallbladder until needed by the small intestine. When the level of cholesterol is disproportionately higher than the other components of bile, the bile becomes saturated and crystals begin to form, eventually developing into stones.
One study undertaken in the UK in the early 1990s indicated normal-weight women who develop gallstones tend to have “slow intestinal transit” or “slow colonic transit.” Sluggish bowels, if you will. Apparently, the slow transit leads to a higher proportion of a particular bile salt responsible for cholesterol secretion.
And it seems women have more of this bile salt than men. Estrogen has also been implicated in the formation of gallstones. Surges at puberty and pregnancy, as well as in supplements through HRT (hormone replacement therapy), increase the cholesterol concentration in bile. Some researchers recommend taking estrogen supplements in patch form, which delivers the hormone through the skin and reduces the effect on the liver.
Has your doctor told you your triglycerides are high? These fatty acids will increase your risk for gallstones. Diabetics especially tend to have high triglyceride levels.
And if you think taking a cholesterol-lowering drug will help protect against gallstones, think again. Blood cholesterol is lowered by increasing the amount secreted into the bile. And how did we say gallstones form? That’s right, higher amounts of cholesterol in the bile.
Inactivity seems to be a factor in developing stones as well. Researchers at the Harvard School of Public Health followed more than 60,000 women over the course of a decade and found that those who engaged in just about any kind of exercise for two to three hours a week had a lower risk for gallbladder surgery, by about 20 percent. The more sedentary women are the higher the risk of gallstones and surgery. Sitting at a desk job or even watching too much TV can increase the odds.
A two-year-old study, originally published in the “Archives of Internal Medicine,” suggested that women who don’t get enough vitamin C might be prone to gallbladder disease. A number of animal studies have already shown vitamin C regulates the conversion of cholesterol into bile acids, so the authors of this study hypothesized the effects might be the same for humans. But an association would be found only in women and not in men. It seems to be that estrogen connection again.
How do you know if you have gallstones? Most people have no symptoms at all. Their “silent stones” are usually found during routine medical exams or exams for other illnesses. But if the gallbladder becomes inflamed, or the stone moves and becomes lodged in a duct, a whole host of symptoms arises, ranging from sharp pain, nausea and vomiting, to fever and jaundice.
Prolonged blockage of any of the bile ducts spells trouble. Infection can easily set in and cause damage to the gallbladder itself, or even the liver and pancreas. These infections most often require hospital treatment and can sometimes be fatal, particularly if left untreated for too long.
The preferred treatment for gallstones that cause recurrent pain is to remove the diseased gallbladder. Today’s method of choice is the laparoscopic cholecystectomy, a procedure that involves minimal cutting and is less invasive than open surgery. Imaging and surgical instruments are inserted through small, 1/4 to 1/2 inch abdominal incisions – the largest through the naval -and the surgeon is guided by a video monitor. This procedure is generally scheduled as outpatient surgery. Many patients go home the same day.
Overall recovery time is far less than traditional open surgery – a matter of days instead of weeks. Most patients report less postoperative pain, and many return to work within one week. The laparoscopic technique is so safe and effective it can even be performed on pregnant women, according to a report in the June 2001 issue of “American Surgeon.”
Don’t play Russian roulette with your gallbladder. See your doctor if any symptoms arise or you have questions about your gallbladder’s health.