Cholelithiasis

Gallstone disease is a common digestive disorder that affects 10%–15% of individuals in developed societies.1 In the United States, the combination of a diet rich in processed foods and sedentary lifestyle predisposes individuals to gallstone formation. Due to the influence of both environment and genetics, the occurrence of gallstones varies greatly, ranging from 2%–70% among different populations, with the highest incidence among Pima Indian women older than 30 years of age.2

There are many risk factors for gallstones. Some of these conditions are not modifiable (e.g. genetics, sex, age, ethnicity, and family history), whereas many conditions can be changed (e.g. such as diet, obesity, physical inactivity, medications, and stress).2,3

Bile aids in the digestion/absorption of lipids from the intestines. Made by the liver, bile is composed of bile acids, cholesterol, and phospholipids. Bile is stored in the gallbladder until a hormone released during eating called cholecystokinin stimulates its release into the intestines. Conditions that lead to gallstone formation include supersaturation of bile with cholesterol, decreased bile acids that dissolve cholesterol, excess mucus production, and gallbladder dysmotility and stasis.

Gallstones are classified as either cholesterol or pigment. In industrialized countries, cholesterol stones account for up to 85%. Most people with gallstones remain asymptomatic. Approximately 20% will develop severe pain in the right upper quadrant of the abdomen near the ribs that can radiate to the back or shoulder.

Immediate surgical referral is warranted in the setting of severe recurring symptoms. Preventing gallstones is much easier than treating them. The same principles of prevention apply to many common chronic diseases (diabetes, heart disease).

  • Maintain a healthy weight, with slow gradual weight loss if body mass index is elevated.
  • Exercise — get moving in a way that is enjoyable and sustainable for you, at least 30 minutes five times weekly.
  • Encourage a diet high in fiber, vegetables, fruit, nuts, and omega-3 fatty acids.
  • Maintain a low intake of saturated fats, refined sugars, and high-glycemic load foods.
  • Remember hydration — drink at least six to eight cups of clean water daily. Consider coffee if you enjoy it, two to three cups daily.
  • Consider supplementation: vitamin C, 200 mg twice daily; magnesium, 300 mg/day; vitamin E, 400 units/day with meals; calcium, 1000 to 1500 mg/day; and curcumin 450 mg/day.

Whether you’re suffering from gallstones or any number of other conditions, come and speak to us at RMRM about how we might be able to help you, including a meeting with our very experienced nutritionist.

  1. L.M. Stinton, E.A. Shaffer: Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut and Liver. 6 (2):172-187 2012 22570746
  2. J.E. Everhart, M. Khare, M. Hill, K.R. Maurer: Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 117:632-639 1999
  3. R.L. Earley, L.S. Blumer, M.S. Grober: The gall of subordination: changes in gallbladder function associated with social stress. Proc Biol Sci. 271:7-13 2004