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Gallstones: Overview and Risk Factors
Gallstones are small, hard stones form in the gallbladder. They
occur in up to 20 percent of women and 8 percent of men worldwide.
Physicians use the term “cholelithiasis” to refer to
the condition of having gallstones.
Most stones are composed of cholesterol and are associated with high–fat, high–cholesterol,
low–fiber diets.
The most common symptom is pain in the upper, right abdomen. The
pain, which generally occurs after eating a large meal, may spread
to the back or right shoulder. In addition, nausea, vomiting, and
burping are common. More severe symptoms, including fever or jaundice
(a yellow discoloration of the skin), may signify infection of the
gallbladder, which is a medical emergency.
Risk Factors
- Increasing age: Gallstones are most common in
individuals over age 40.
- Female gender: Females are more likely to develop
gallstones, probably due to the effects of estrogens. This increased
risk is particularly striking in young women, who are affected
three to four times more often than men of the same age.
- Family history: Gallstones are more than twice
as common in first–degree relatives of patients with gallstones.
- Elevated estrogen and progesterone: Pregnancy,
oral contraceptives, and hormone “replacement” therapy
are associated with elevated levels of estrogen and progesterone,
which increase the risk for gallstones.
- Obesity
- Rapid weight loss: Bariatric surgery and very–low–calorie
diets increase risk of gallstone formation.
- High–fat diets: See Nutritional Considerations.
- Coexisting medical diseases: Cirrhosis increases
the risk of gallstones by as much as 10 times. Other diseases that
increase the risk include diabetes mellitus, Crohn’s disease,
sickle cell anemia, and spinal cord injury.
- Medications, including clofibrate and ceftriaxone
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