Gallstones & High-Fat Foods: The Silent Danger

     Some patients with gallstones may remain asymptomatic until they are discovered later during an abdominal ultrasound. 'Abdominal pain' is a common sign found by physicians, mostly occurring under the right rib cage, which can be either acute or chronic. Advanced age, having multiple children, and obesity from high-fat diets are all risk factors. One major solution is often the surgical removal of the gallbladder.

Gallstones

     Gallstones (Cholelithiasis) is a condition caused by the precipitation of compounds in the bile into stones that obstruct the gallbladder. These stones can occur in various numbers and sizes, from tiny grains to the size of a golf ball. They can be caused by abnormal gallbladder contractions, easy breakdown of red blood cells, or an imbalance in bile components, such as excess cholesterol.

Types of Gallstones

The types of gallstones are categorized by their cause; therefore, the 'color of the stones' is different.

• Cholesterol Stones: Caused by high cholesterol levels mixed with other waste products in the bile. The highly concentrated fluid crystallizes into white, yellow, or green stones. In some cases, it occurs because the gallbladder muscles do not contract well, causing fluid to accumulate and precipitate into stones.
• Pigment Stones: Found in 15 – 20% of cases, mostly in patients with blood disorders where there is excessive breakdown of red blood cells. This breakdown leads to high levels of bilirubin, which combines with bile to precipitate into "Dark Brown" or "Black" stones.

Symptoms of Gallstones

• Abdominal tightness after consuming fatty foods.
• Pain in the right rib cage area, spreading to the back and under the shoulder blade.
• Bloating, heartburn, and indigestion.
• Nausea and vomiting.
• Jaundice (yellowing of the skin and eyes) and dark urine.

Diagnosis of Gallstones

     Currently, doctors can detect signs of the disease more easily using abdominal ultrasound. Furthermore, for hidden lesions in hard-to-reach areas, high precision is provided by Endoscopic Retrograde Cholangiopancreatography (ERCP) which can also be used to remove stones from the bile duct simultaneously. In cases where patients have asymptomatic gallstones, close monitoring by a physician is necessary.

Who is at Risk of Gallstones?

• Aged 40 and above, occurring more frequently in women than men.
• Obesity, due to regular consumption of high-fat foods.
• Having multiple children; the gallbladder may contract less, leading to easier precipitation.
• Family history of gallstones.
• Use of certain medications and history of gastric surgery.

Gallstones: More Dangerous Than You Think

The dangers arising from gallstones start within the gallbladder itself.

• Stones obstructing the cystic duct: Patients seeking medical attention while symptomatic often suffer from cholecystitis (gallbladder inflammation).
• Stones passing into the common bile duct: This may cause jaundice and infection in the biliary tract.
• Stones obstructing the small intestine: If a stone is very large and creates a fistula between the gallbladder and the intestine, it can block the digestive tract, causing severe bloating and vomiting. This requires urgent surgery.

Gallstones also cause inflammation in surrounding tissues. Prolonged friction with the gallbladder wall can eventually lead to the development of gallbladder cancer.

Treatment for Gallstones

     Treatment for gallstones depends on the stage of the disease. Cholecystectomy (surgical removal of the gallbladder) is the primary key to treatment, with the physician considering what is appropriate for each individual. Laparoscopic cholecystectomy is currently the standard procedure, helping patients recover faster than traditional open surgery. Some patients can go home on the same day, though most may stay in the hospital for 1-2 days for observation.

Preventing the Disease by Focusing on What is ‘Controllable’

• Move and exercise regularly.
• Be mindful of food choices; reduce "bad fats," especially high saturated fats from fatty meats, fried foods, and bakery items.
• Increase intake of "good fats" (HDL) from fish or vegetable oils instead.
• Maintain a stable body weight and avoid rapid weight loss (more than 1.5 kg per week).
• Eat high-fiber foods such as vegetables, fruits, and unrefined grains to aid digestion, reduce bile acid precipitation, and help control cholesterol levels.