Gallstones and Gallbladder Disease - Risk Factors

(Page 3)

Highlights	Prevention	Extracorporeal Shock Wave Lithotripsy
Introduction	Diagnosis	Other Procedures
Symptoms	Treatment	Resources
Prognosis and Complications	Surgery	References
Risk Factors	Open or Laparoscopic Common Bile Duct Exploration (Choledocholithotomy)

The risk for gallstones is as high as 12% after 8 -16 weeks of restricted-calorie diets.
The risk is more than 30% within 12 - 18 months after gastric bypass surgery.

About one-third of gallstone cases in these situations have symptoms. The risk for gallstones is highest in the following dieters:

Those who lose more than 24% of their body weight
Those who lose more than 1.5 kg (3.3 lb.) a week
Those on very low-fat, low-calorie diets

Men are also at increased risk for developing gallstones when their weight fluctuates. The risk increases proportionately with dramatic weight changes as well as with frequent weight cycling.

text continues below

Bariatric Surgery. Patients who have either Roux-en-Y or laparoscopic banding bariatric surgery are at increased risk for gallstones. For this reason, many centers request that patients undergo cholecystectomy before their bariatric procedure. However, doctors are now questioning this practice.

Metabolic Syndrome

Metabolic syndrome is a cluster of conditions that includes obesity (especially belly fat), low HDL (good) cholesterol, high triglycerides, high blood pressure, and high blood sugar. Research suggests that metabolic syndrome is a risk factor for gallstones.

Low HDL Cholesterol, High Triglycerides and Their Treatment

Although gallstones are formed from the supersaturation of cholesterol in the bile, high total cholesterol levels themselves are not necessarily associated with gallstones. Gallstone formation is associated with low levels of "good" HDL cholesterol and high triglyceride levels. Some evidence suggests that high levels of triglycerides may impair the emptying actions of the gallbladder.

Unfortunately, some fibrates (drugs used to correct these conditions) actually increase the risk for gallstones by increasing the amount of cholesterol secreted into the bile. These medications include gemfibrozil (Lopid) and fenofibrate (Tricor). Other cholesterol-lowering drugs do not have this effect. [For more information, see In-Depth Report #23: Cholesterol.]