Back to the stone age
Key takeaways:
- Today, the gallbladder is not as essential for humans. But issues, like gallstones, still arise.
- Most people with gallstones don't have symptoms. Others have pain in their midsection, nausea or vomiting. Symptoms may get worse over time.
- If your quality of life is greatly impacted, a doctor may remove your gallbladder.
- There's not much you can do to prevent gallstones, but being overweight doesn't help.
Greg Ward, MD, has a history lesson.
Thousands of years ago, he says humans used to kill a wild animal and eat well for a couple days. Then, they may go a few days or more without fatty meat. The gallbladder would be well at work. The organ stores bile, which helps absorb fat and keep you nourished.
Today, we eat three regular meals per day, and Dr. Ward, an OSF HealthCare general surgeon, says the storage vessel isn’t as critical. But it still presents problems from time to time. Most notable are gallstones.
Gallstones basics
Dr. Ward says gallstones are, most of the time, made of cholesterol. Others, called pigment gallstones, are made of a substance called bilirubin. People with sickle cell anemia whose body is destroying a lot of red blood cells may have pigment gallstones, he says.
Why do gallstones form? Good question, doctors will probably respond.
“You can have a very high cholesterol level in your bile and not precipitate out stones. Other people have a lower level of cholesterol and get a bunch of stones,” Dr. Ward says.
“So, we’re not quite sure. It’s something in the biochemistry in the wall of the gallbladder that protects us [from gallstones]. Some people don’t have that,” he adds.
Symptoms and treatment
Dr. Ward says 85% of people with gallstones don’t have symptoms. Health care providers find them on an ultrasound when looking into kidney issues or a pregnancy.
“Just because you have gallstones doesn’t mean you need to do anything about them,” Dr. Ward says.
The time to see your primary care provider or an urgent care: “If you’re having severe pit-of-the stomach pain about a third of the time. Two-thirds of the time, pain toward the right upper quadrant [of your midsection]. Pain that doubles you over. Usually with some nausea or vomiting. Typically, after a heavy, fatty meal.”
Moreover, Dr. Ward says gallstones tend to get worse over time. You may begin with one bout of symptoms per year. Five years later, you may be in severe pain once every two months. So, Dr. Ward says people typically talk with him about their quality of life and the right time to remove the gallbladder. Typically, the person goes home the same day after the procedure.
“The gallbladder is not missed,” Dr. Ward says.
“Maybe 10% to 20% of people get some loose stool when they eat fatty food. That goes down to about one in 100 [people] over time,” Dr. Ward says. “But some people need to minimize the amount of fatty food in a meal to avoid the loose stool.”
Prevention
Dr. Ward says it’s tough luck when trying to avoid the four Fs that are the major risk factors for gallstones. In other words, we can’t control them: being female, being fertile, being 40 or older and having a family history of stones.
Otherwise, he says being overweight can put you at risk. So, commit to a healthy diet and exercise.
“The actual fat you’re eating isn’t what does it. It’s total weight,” Dr. Ward explains.