Peanut butter and gallbladder

10 Essential Facts About Your Gallbladder

Hanging out just below the liver’s right lobe is your hollow, pear-shaped gallbladder. When it’s full of bile that’s waiting to help digest some food, the organ can grow as long as 8 to 10 centimeters (cm), and as wide as 4 cm.

Unless you’ve had a gallstone or your gallbladder has been surgically removed, you probably think little of it. And that’s fine. But if it’s causing you serious pain or other problems, you may need to ditch this little organ.

1. Your gallbladder serves as a storage pouch.

While the liver is hard at work making the dark green bile that helps with digestion, the gallbladder holds the bile until you actually need it, says Erin Gilbert, MD, an assistant professor of surgery at Oregon Health and Science University in Portland. “It concentrates the bile into the form that’s best used for digestion,” Dr. Gilbert says. “When you eat, the bile is squeezed out of the gallbladder and goes into the first part of the small intestine, the duodenum, through the common bile duct.”

The liver produces anywhere from 500 to 1,000 milliliters (ml) of bile per day, but the gallbladder can concentrate that bile up to tenfold and store 30 to 50 ml of the denser bile.

2. Gallstones are formed mostly from hardened cholesterol.

Gallstones form when one of two substances — cholesterol or bilirubin — become supersaturated in the bile and crystallize, much the way sugar crystallizes when someone makes rock candy. Bilirubin is a brownish-yellow substance found in bile that results when old red blood cells in the liver break down. Your body normally eliminates bilirubin through your bowels (it’s the reason for the color of feces). Bilirubin-caused gallstones are rarer than those formed from hardened cholesterol, and are more common in those with blood disorders, such as sickle cell anemia.

3. A low-cholesterol and low-fat diet is best for a healthy gallbladder.

What’s the best diet for a healthy gallbladder? “Most gallbladder stones are formed from cholesterol, so eating a low-cholesterol and low-fat diet is best for gallbladder health,” says Cathleen Khandelwal, MD, a general surgeon at Cleveland Clinic.

4. A diet good for your heart is good for your gallbladder, too.

Any diet that would qualify as “heart-healthy” is “gallbladder-healthy,” too. That means a diet with some healthy monounsaturated fats, such as those in nuts, avocados, seeds, olives, peanut butter, and the oils from these products. Polyunsaturated fats should be part of that balanced diet, too, and are found in fatty fish, walnuts, flaxseeds, and vegetable oils. Avoiding foods that increase your cholesterol levels also reduces the risk of gallstones.

Almost as important as what you eat, however, is how frequently you eat. “If you eat one large meal a day, it increases the likelihood of stones, because the bile sits in the gallbladder for a long period of time before it’s excreted,” Gilbert says. The longer bile sits around, the more time there is for cholesterol in the bile to become supersaturated and crystallize into gallstones.

5. Rapid weight loss could cause gallstones.

In addition to a healthy diet, a healthy weight keeps the gallbladder functioning well. Individuals with obesity have a higher risk of gallstones, but that doesn’t mean you should go on a crash diet to lose weight: Rapid weight loss can cause stones, too, Gilbert says. It’s fine to lose weight, but “you wouldn’t want to lose it all at once,” she says.

Another way to stave off stones is to keep your cholesterol under control, including by taking statins if you have high cholesterol, she says. Some evidence supports regular vitamin C supplements to prevent gallstones, and oddly enough, drinking coffee appears to offer some protection against gallstones formed by cholesterol, too.

6. Close to 12 percent of the population has gallstones, but only a few cause problems.

In addition to those with obesity, and those who eat a poor or high-fat diet or have high cholesterol levels, pregnant women are also more likely to get gallstones, which means they may need to pay extra attention to fatty foods during pregnancy. Those with certain blood disorders, such as sickle cell anemia, may have a higher risk of the bilirubin-caused stones.

Older adults and people of certain ethnicities, such as Native Americans, also have a higher risk of gallstones, and having a family history of them can double your risk of developing one. Certain medications, such as oral contraceptives, may increase the risk of gallstones, but the increased risk is small and should not prevent someone from taking the needed medication.

In fact, up to 12 percent of the population has gallstones, Gilbert says, but only a minority of those cause problems.

7. The most common sign of gallstones is intense pain.

Up to 80 percent of people will never have symptoms for their gallstones, and nothing needs to be done about that, says Gilbert. But if there is a problem, you’ll usually know it: the pain can be intense. “The pain is generally described as sharp, stabbing, and very excruciating — a 10 on a scale of 1 to 10,” Gilbert says. The pain most commonly comes after eating a fatty meal because “fat is the strongest trigger for the gallbladder to empty,” she says.

The where your gallbladder is, below your breastbone, and can radiate to your back, Dr. Khandelwal says. It can last several hours and may be accompanied by nausea, she adds.

But the pain can also be a dull ache on the right side, like an upset stomach or heartburn with bloating, Gilbert says.

8. The best test for gallstone is an ultrasound.

The best test for gallstones is an ultrasound. “It’s quick and safe and gives us a lot of information about how the gallbladder looks, and it has pretty high accuracy,” Gilbert says. The ultrasound tech will be able to see gallstones or gallbladder irritation, such as a thickened wall or fluid around the gallbladder.

Some patients may be referred for a second kind of test called an HIDA (hepatobiliary) scan, in which a radioactive chemical is injected into your arm and the tech watches what happens when it reaches your gallbladder. Generally, HIDA scans are only performed on patients who have other underlying conditions or who have gallbladder pain symptoms, but no stones on an ultrasound.

9. Escaped stones could lead to jaundice or pancreatitis and require surgery.

If it’s not causing symptoms, or if you pass it as a few lucky people do, nothing. “But if they are causing trouble,” Gilbert says, the gallbladder may need to be removed. If the person is experiencing pain, called biliary colic, or develops a gallbladder infection, called cholecystitis, gallbladder surgery is probably in the stars.

“If the stones get outside your gallbladder and travel down the duct, they can cause some pretty serious complications, so it’s important to have them taken care of if you’re having a problem,” Khandelwal says.

Escaped stones can cause obstructions in the ducts that lead to jaundice or pancreatitis, Gilbert says. Any of these symptoms would require gallbladder surgery, called cholecystectomy.

10. Gallbladder removal surgery is usually an outpatient procedure.

If you need a cholecystectomy, or gallbladder removal surgery, it will usually mean a week or two off from work. The laparoscopic surgery involves one incision by the belly button, and two or three under the ribs on the right, Gilbert says. Although it’s usually an outpatient surgery, it does require general anesthesia because the surgeon will fill the abdomen with carbon dioxide to expand it and make it easier to work.

Expect three to five days of soreness, which may require narcotic pain medication, and avoid strenuous activities for at least two weeks, Gilbert says. People typically fully heal within four to six weeks and may experience diarrhea in the short-term.

Maybe one to two percent of people will have loose stools whenever they eat particularly fatty or greasy meals, Gilbert says. But removing the gallbladder should not cause weight loss or weight gain, and will not cause any vitamin deficiencies.

Most people without a gallbladder should not expect other changes over the long-term. “In fact, they’ll be able to eat things they couldn’t before,” Khandelwal says. “The liver continues to make bile and drip it into the stomach and intestines. It may take a little longer to digest fried chicken, but maybe not.”

What Not To Eat If You Have Experienced A Gallbladder Attack

What Not To Eat If You Have Experienced A Gallbladder Attack

More people suffer from gallbladder attacks than many of us probably think. Many patients see no symptoms while some experience large amounts of pain, inflammation, and potentially very serious consequences. If you have had a gallbladder attack, a large part of why people experience these types of attacks of pain is due to their diet. Treating gallbladder pain and gallstones begins with addressing what not to eat.

Foods To Avoid

Designing a diet that is appropriate for a person suffering from gallbladder attacks involves limiting the amount of foods consumed that are high in fats or high in sugars. Note that this is not to ‘eliminate entirely’ but to ‘limit the amount’.

Fatty Foods – Fried Foods

Avoid fried foods. If your body is having trouble breaking down cholesterol resulting in gallstones, this is a must. Therefore avoid foods such as French fries, onion rings, doughnuts, fritters, pastries and even vegetables that are fried.

Milk Products And Saturated Fats

Avoid Saturated fats. So when we talk saturated fats, this means the fats that are in animal products such as butter, cheese, meat, cakes, biscuits, and pastries. Now some of these foods, particularly meat, are likely to find their way into your diet no matter what. The key is to be aware of the amount of food being consumed and not to add to that amount with additional saturated fats. For example, using alternatives such as sunflower oil or olive oil, avocados, nuts and seeds all can have a positive impact.

Also in the saturated fat category of foods you want to avoid is whole milk, buttermilk, cream, butter, sour cream, non-dairy creamer, whole-milk cheese, cheese spreads, chocolate milk and ice cream. Instead, you want to use alternatives and choose skim or 1 percent milk, yogurt made from skim milk, fat-free cheese, low-fat cottage cheese, skim buttermilk and non-fat sour cream.

Processed Foods

The next step to being aware of low fats and low sugar is to cut out and avoid processed foods. Cook from scratch whenever possible and gain better control of the fat that is entering your body.


Reducing meat is also a recommended strategy that not so many patients like to hear but it is key in giving the body a chance to rehabilitate. Many patients find that replacing part of their meat portion with something like kidney beans and/or mushrooms can help to diversify a meal and make this more achievable without completing removing meat from your plate.

As stated earlier, the avoidance of meat plays a huge role in structuring a diet to target gallbladder pain. If you do eat meat, make sure to avoid the meat that is higher in saturated fat and cholesterol, especially fried, fatty or heavily marbled meat, beef, spareribs, ham hocks, ground beef, eggs, tuna and salmon canned in oil, sausage, hot dogs, hamburger, duck, goose, gravy and peanut butter. Once again, you want to replace these with alternatives such as lean meats, cold water fish, poultry without skin, lean beef, pork, lamb, tuna packed in water, fat-free luncheon meats, tuna or salmon packed in water, and tofu.


Eggs should be limited to no more than three eggs per week. They are rich in calories, fat and cholesterol despite being a good source of protein and choline. When you do have eggs, prepare them by scrambling or poaching with as little fat as possible.

The final point that must be made is perhaps the most obvious one. Being aware of what not to eat when suffering from gallbladder attacks is a part of the process to rehabilitating the body, getting rid of the toxicity present in both the liver and the gallbladder, and putting an end to gallstones once and for all.

If you want more information on what not to eat for gallstones or how to address gallbladder pain, please visit and learn about the most appropriate diet for your situation.


Psst – below is the original post about this topic but I have posted an update – check it out!

Time for a bit of a side story on my blog. I do talk about this frequently within my bento posts, but I’ve recently been thinking that a couple of specific posts on it would help some people. When I first had my gallbladder out, it would have been such a help to me if I could have found a range of blogs and websites about specific transitions in eating after a gallbladder removal, but alas, it’s mainly medical sites out there :S

This blog post will be specific to my food do’s and don’ts; what I eat and don’t eat, why I eat or avoid those things and other tips. This may help some of you, but please excuse my rambling if it doesn’t 🙂

My food do’s:

– Do always have breakfast – as bile is constantly dripping into my digestive system, not eating for long periods of time makes it uncomfortable (like acid burn), so I always eat breakfast, even if it is just a banana.

– Do up the protein – processed carbs cause me issues and comfortableness if I eat them too often, so I make sure I eat more protein. The protein I eat includes cottage cheese, low fat natural and flavoured yogurts, edamame, fish, chicken, chickpeas (hummus), lentils and quorn.

– Do enjoy your fruit and veg – I can eat all fruit and veg, bar one or two things (although when my stomach isn’t feeling great, I avoid raw vegetables). I’m not able to eat radishes as it was one of my trigger foods, but I always get my 5-a-day in so many different ways; smoothies, soups, snack pots, dipping, baked, roasted, stir fried, steamed 😀 I especially like baked apples with a sprinkling of oats on top!

– Do snack – again, due to the bile, it is better for me to never have an empty stomach for too long, so, snack it is! I love home popped popcorn, with paprika and pepper on it, or hummus and veggies, or good old rice cakes. I even like sliced apple with a small amount of choccy spread!

– Do exercise! – exercise is a fantastic non-medical way to help with digestive problems. Running, for me is what keeps things moving (apologies for the term!). If there is anyone who has digestive problems after a gallbladder removal, then exercise!! It will solve it!! Exercise how you are able to though, so even a short walk in the fresh air or a nice swim will help.

My food don’ts:

– Don’t eat high fat items often – high fat items, for me, include peanut butter, most nuts, full fat dairy (including cream, milk, cheese and yogurt), fast food (especially battered items), fatty meats and high fat carb items (like pastries) and whole eggs. I have some of these very occasionally but if I eat them too often or eat too much of them, my digestive system does not cope so well and it isn’t comfortable.

– Don’t overeat! – no-one should overeat anyway, it’s not good for you, but having no gallbladder to control the flow of bile means that a very large meal can take a very very long time to digest, which equals the very full feeling for a very long time (for me). I do eat large meals sometimes, but I am a lot more conscious of how overeating affects me.

– Don’t worry! – Stress exacerbates a lot of conditions, and it also makes for a unhappy digestive system. By stress I mean worrying about eating the right foods or too much of the not so good foods. Don’t worry! Your main aim should always be to eat lots of fruit and vegetables. I have found all the rest will balance itself out due to being full up on all the good stuff!! Exercise also helps all forms of stress, so get moving!

Overall, just be happy. I get aches and pains sometimes, that are directly to do with the scar tissue from the op. But guess what? They are small aches. Not the excruciating pain I was in when I had my silly gallbladder. I can cope with these, I can enjoy my life, and I am happy and healthy!

Have you got any food do’s and don’ts that are specific for yours or your familys needs?

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The Link Between Gallstones, Obesity, and Weight Loss

Gallstones are rock-hard deposits that develop in the gallbladder, a small organ in the upper right abdomen just below the liver. Gallstones can be so small they’re barely visible, or as large as a golf ball. They can exist singly or by the hundreds. And they can be asymptomatic or excruciatingly painful.

Gallstones are formed when bile, which aids in the digestion of fat, contains too much cholesterol or bilirubin and not enough bile acids or lecithin (substances that allow water- and oil-based liquids to mix). Cholesterol gallstones are the most prevalent type, but stones made from bilirubin (called “pigment gallstones”) are also common.

Obesity can lead to gallstones because it “alters the balance of cholesterol versus lecithin versus bile acids in the gallbladder,” says William Silverman, MD, professor of medicine in the division of gastroenterology and hepatology at the University of Iowa Hospitals and Clinics in Iowa City. Excess body weight also makes it more difficult for the gallbladder to empty, says Dr. Silverman, and this allows cholesterol-rich bile to accumulate and harden into stones.

How to Lose Weight Safely to Reduce Your Risk of Gallstones

Losing excess weight is a surefire way to reduce your risk of gallstones. Most experts agree that slow, steady weight loss is preferable to crash diets, which is especially important when it comes to gallstones. Rapid weight loss, meaning 3 or more pounds (lbs) per week, can trigger gallstones for the same reasons as obesity — it alters the balance of cholesterol, lecithin, and bile acids, and prevents the gallbladder from emptying adequately.

People who have had bariatric surgery are prime candidates for gallstones because they tend to lose a significant amount of weight in the first three to six months. The type of surgery doesn’t matter, says Silverman, because “it’s the weight loss that precipitates stones rather than the actual surgery.”

Gallstones are such a common occurrence after bariatric surgery that patients are routinely given ursodiol, a medication that helps prevent stone formation by decreasing cholesterol production and dissolving it in bile.

Weight loss of ½ to 2 lbs per week is a good goal for most people. Modest weight loss not only helps prevent gallstones, it also encourages new habits that can help put an end to losing and regaining weight repeatedly — and weight cycling is another risk factor for gallstones.

When it comes to gallstone prevention, the type of food you eat doesn’t really matter, says Silverman; the important thing is to avoid eating too much. That being said, extremely low-fat diets are not a great idea because they inhibit gallbladder contractions, making it harder for the gallbladder to empty and allowing bile to accumulate and calcify instead of being released into the small intestine.

Weight loss is best achieved with increased activity and a sustainable diet that doesn’t leave you feeling hungry, fatigued, or deprived. A customized eating plan combined with these fad-resistant strategies will help you achieve your goals:

  • Plan your meals in advance, especially when eating out. Menus are often posted online, which makes this a lot easier.
  • Keep a food journal. People who log everything they consume within 15 minutes of eating lose more weight than those who either don’t keep a journal or who wait to record their entries.
  • Create a file (online or hard copy) of your favorite low-calorie recipes, and try to always have a stash of key ingredients in your fridge or cupboard.
  • Keep healthy, low-calorie snacks in your home, office, car, bag — wherever! This will help you stay on track when the munchies hit and the only thing around is junk food.
  • Identify and address “triggers” for unhealthy eating. This may be as simple as moving a candy dish off your coffee table or as challenging as getting to the bottom of why you eat when stressed or bored.
  • Eat only until you’re satisfied, not until you’re stuffed. If you eat slowly and mindfully, you’re less likely to overeat because it takes about 15 to 20 minutes for your brain to register that your stomach is full.
  • Try not to multitask while eating. Turn off the TV, power down your computer, and don’t take or make calls during meals. Talking to dining companions is A-OK, of course — you can’t (or shouldn’t) talk and eat at the same time, so a good conversation can help extend the mealtime and prevent overeating.
  • Make sure you get enough sleep. Sleep deprivation sets you up for weight gain by increasing hunger and decreasing your ability to resist comfort foods.

Finally, don’t expect to be perfect. Stuff happens, and you can’t always control what, where, and how you eat. The occasional extra piece of pizza or a couch potato day will not ruin your weight loss efforts or result in a spontaneous gallstone. Just try to learn from the experience so you can prevent it from happening again, and then get right back to your healthy eating and exercise plan.

RELATED: 5 Sneaky Reasons You’re Overeating — And How to Stop

Waist Away Gallstones

Having a fat tummy – even if your body mass index (BMI) is within the normal range – could mean you’re more likely to develop gallstones and need surgery to remove them, according to a new study published in the journal Gut.

Researchers studied more than 42,000 women aged between 39 and 66 for 14 years. During this time, more than 3,000 women needed gallstone surgery. However, those with a waist measurement of 36 inches or more were almost twice as likely to need surgery to remove their gallstones compared with those with waists measuring 26 inches or less. The reason for this link is likely to be because fat around the waist is more metabolically active than the fat elsewhere in the body, say the researchers.

WLR says:

It’s well established that being an ‘apple’ shape – where excess fat is stored around our waists – increases the risk of several medical complaints, including type 2 diabetes, high blood pressure and heart disease. However, few previous studies have found that rounded waistlines also increase the risk of needing surgery for gallstones.

Gallstones occur more commonly as we get older and approximately one in 10 people over the age of 40 have them, with women aged between 20 and 60 years being twice as likely to develop them as men.

Gallstones are made when excess cholesterol in the bile – a substance that digests fat – forms crystals in the gall bladder. This small, pear-shaped organ, located just under the liver and the ribs on the right hand side of the body, may also empty too slowly causing the crystals to stagnate.

Many people with gallstones have no symptoms but they can cause severe pain just below the ribs on the right-hand side of the body. This pain may travel to the back between the shoulder blades or to the right shoulder and may also be accompanied by nausea and vomiting.

Attacks are often triggered by eating fatty foods and are sometimes linked with bloating, belching and indigestion.

A low-fat diet may be helpful in relieving the symptoms of gallstones – and also has the advantage of aiding Weight Loss. However, if symptoms don’t improve or there are signs of infection in the gall bladder, surgery may be necessary. Usually this is done by keyhole surgery and involves removing both the stones and the gall bladder.

Fortunately, losing weight is one of the most important things you can do to stop gallstones from forming in the first place. A large clinical study shows that being even moderately overweight increases the risk for developing gallstones, possibly because it tends to reduce the amount of bile salts in bile, resulting in more cholesterol, and slows down the emptying of the gallbladder.

Having said this, fasting and losing weight rapidly also increases the risk of gallstones. This is because as the body metabolises fat during rapid Weight Loss, it causes the liver to secrete extra cholesterol into the bile, potentially causing gallstones. Meanwhile, fasting slows down the emptying of the gallbladder causing cholesterol to build up in the bile. As a result, it’s important to lose any excess pounds slowly.

Finally, to lower your risk of many diseases, it’s also worth checking out whether you have too much fat stored around your middle – even if your BMI is normal. This is as simple as measuring your waist.

For men, you’re at an increased risk of health problems if your waist measures 37in (94cm), and at high risk if it measures 40in (102cm) or more.

For women, your risk is increased if your waist is 32in (80cm) and you’re at high risk if it’s 35in (88cm) or more.

If you’re at an increased risk, it’s a good time to start making some lifestyle changes to lower your risk of disease. If you’re at high risk then losing fat from your midriff will almost certainly benefit your health.

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In Brief: Link found between abdominal fat and gallbladder surgery

In Brief

Link found between abdominal fat and gallbladder surgery

Published: May, 2006

Harvard researchers have discovered one more reason to watch our waistlines: avoiding gallstone surgery. Their study, published in the journal Gut (Feb. 14, 2006), found that women who accumulate weight around the middle are more likely to need cholecystectomy — surgery to remove the gallbladder. The research suggests that waist measurement may be a better predictor of gallbladder risk than body mass index (BMI).

Gallstones often produce no symptoms and require no treatment. But they can cause severe pain, jaundice, and inflammation of the gallbladder, bile duct, and pancreas. As a result, 800,000 cholecystectomies are performed each year in the United States. Compared to men, women are twice as likely to have gallstones, and the risk increases with age. The Gut study analyzed 14 years of data from 42,312 participants in the Nurses’ Health Study. At the outset, none had gallbladder disease; by the end of the study period, the group had undergone 3,197 gallbladder surgeries.

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Definition & Facts for Gallstones

In this section:

  • What are gallstones?
  • Do gallstones have another name?
  • What is the biliary tract?
  • How common are gallstones?
  • Who is more likely to develop gallstones?
  • What are the complications of gallstones?

What are gallstones?

Gallstones are hard, pebble-like pieces of material, usually made of cholesterol or bilirubin, that form in your gallbladder. Gallstones can range in size from a grain of sand to a golf ball. The gallbladder can make one large gallstone, hundreds of tiny stones, or both small and large stones.

When gallstones block the bile ducts of your biliary tract, the gallstones can cause sudden pain in your upper right abdomen. This pain is called a gallbladder attack, or biliary colic. If your symptoms continue and they’re left untreated, gallstones can cause serious complications.

However, most gallstones don’t cause blockages and are painless, also called “silent” gallstones. Silent gallstones usually don’t need medical treatment.

Types of gallstones

The two main types of gallstones are

  • cholesterol stones
  • pigment stones

Cholesterol stones are usually yellow-green in color and are made of mostly hardened cholesterol. In some countries, cholesterol stones make up about 75 percent of gallstones.1

Pigment stones are dark in color and are made of bilirubin. Some people have a mix of both kinds of stones.

Gallstones can range in size from a grain of sand to a golf ball.

Do gallstones have another name?

Cholelithiasis is the name doctors sometimes call gallstones.

What is the biliary tract?

Your biliary tract, which is made up of your gallbladder and bile ducts, helps with digestion by releasing bile.

The gallbladder is a small, pear-shaped organ that stores bile and is located in your upper right abdomen, below your liver.

The bile ducts of your biliary tract include the hepatic ducts, common bile duct, and cystic duct. Bile ducts also carry waste and digestive juices from the liver and pancreas to the duodenum.

Your liver produces bile, which is mostly made of cholesterol, bile salts, and bilirubin. Your gallbladder stores the bile until it’s needed. When you eat, your body signals your gallbladder to empty bile into your duodenum to mix with food. The bile ducts carry the bile from your gallbladder to the duodenum.

Your biliary tract, which is made up of your gallbladder and bile ducts, helps with digestion by releasing bile.

How common are gallstones?

Gallstones are very common, affecting 10 to 15 percent of the U.S. population, which is almost 25 million people. About a quarter of the nearly 1 million people diagnosed with gallstones each year will need to be treated, usually with surgery.2

Who is more likely to develop gallstones?

Certain groups of people have a higher risk of developing gallstones than others.3

  • Women are more likely to develop gallstones than men. Women who have extra estrogen in their body due to pregnancy, hormone replacement therapy, or birth control pills may be more likely to produce gallstones.
  • Older people are more likely to develop gallstones. As you age, the chance that you’ll develop gallstones becomes higher.
  • People with a family history of gallstones have a higher risk.
  • American Indians have genes that raise the amount of cholesterol in their bile, and have the highest rate of gallstones in the United States.
  • Mexican Americans are also at higher risk of developing gallstones.

American Indians have genetic factors that make them more likely to develop gallstones.

People with certain health conditions

You are more likely to develop gallstones if you have one of the following health conditions:

  • cirrhosis, a condition in which your liver slowly breaks down and stops working due to chronic, or long-lasting, injury
  • infections in the bile ducts, which can also be a complication of gallstones
  • hemolytic anemias, conditions in which red blood cells are continuously broken down, such as sickle cell anemia
  • some intestinal diseases that affect normal absorption of nutrients, such as Crohn’s disease
  • high triglyceride levels
  • low HDL cholesterol
  • metabolic syndrome, which can also raise the risk of gallstone complications
  • diabetes and insulin resistance

People with diet- and weight-related health concerns

You are more likely to develop gallstones if you

  • have obesity, especially if you are a woman
  • have had fast weight loss, like from weight-loss surgery
  • have been on a diet high in calories and refined carbohydrates and low in fiber

Learn more about dieting and gallstones.

What are the complications of gallstones?

Complications of gallstones can include

  • inflammation of the gallbladder
  • severe damage to or infection of the gallbladder, bile ducts, or liver
  • gallstone pancreatitis, which is inflammation of the pancreas due to a gallstone blockage

Many people do not have symptoms of gallstones until they have complications.

If left untreated, gallstones can be deadly. Treatment for gallstones usually involves gallstone surgery.

5 facts about gallstones

Posted on: 20th October 2019

One in ten adults in the UK suffer from gallstones. Gallstones are lumps of solid material that form in the gallbladder, which is connected to the intestine and liver by small tubes called bile ducts.

Bile ducts allow bile, a fluid that helps with digestion, to flow from the liver, through the pancreas, to the gut.

Gallstones usually look like small stones or gravel, but can be as small as sand or as large as pebbles, sometimes filling the gallbladder. They may take years to grow and there may be one or several.

1. The gallbladder is shaped like a pear

The gallbladder is a small, pear-shaped pouch about three to six inches long. It is tucked just under the liver, below the right rib cage and is connected to the intestine and liver by small tubes called bile ducts. Bile ducts carry bile, a yellow-green fluid produced by your liver. Bile contains water, cholesterol, phospholipids and chemicals to aid digestion (bile acids), as well as waste products for excretion via the bowel, such as bilirubin.

2. Gallstones are more common in women

Gallstones are very common, particularly in women. About one in four women and one in eight men develop gallstones at some stage in their life.

3. Cholesterol is the main cause of gallstones

8 out of 10 causes of gallstones is cholesterol, which is a fatty substance found in your blood and in many of the foods we eat. Cholesterol stones form when cholesterol levels in your bile are much greater than your bile acid levels, this causes the cholesterol in your bile to solidify.

Not everyone with high cholesterol levels in their bile develops gallstones, it is not fully understood why some people have them and others don’t.

4. An ultrasound can spot gallstones

Most stones within the gallbladder can be clearly seen on an ultrasound scanner. An ultrasound scan is a routine procedure; the same technology is used in pregnancy. It is usually performed in the X-ray department of the hospital or in an outpatient’s clinic.

5. Sometimes gallstones do not require any treatment

If gallstones have been discovered incidentally and are not troublesome, it is often recommended to leave them alone. In this case, your doctor may want to adopt a ‘watchful waiting’ policy, which means your symptoms will be monitored to see if they progress before treatment is considered.

Waiting to see if further symptoms develop is quite common and safe but you should look out for any deterioration in your condition and report any symptoms to your GP. If your symptoms persist, your doctor will recommend that you are referred for treatment.

To find out more about the causes, symptoms, diagnosis and treatment of gallstones, please visit our gallstones page here.

Important Facts to Know about Gallstones

Olivia HowardFollow Feb 26, 2018 · 3 min read

How do you feel when you get to know that there is a possibility of stones forming in certain parts of your body? I am sure such feelings freaks you out, and you may begin to wonder how things like this are even possible. Certain factors can lead to the formation of stones or solid deposit in the body, and when these stones are formed in the gallbladder, it is called gallstones or cholelithiasis or biliary calculus.

Gallstones are solid or harden deposits of digestive fluid in the gallbladder; these stones vary in size (from the size of a peanut to the size of the gallbladder) and number. It is a condition that mainly results from hormonal imbalance that relies on the production of excess cholesterol and sometimes excess bilirubin in the bile. The condition causes sudden or intense pain in the upper-right section of the abdomen and back in sufferers. Many people have gallstones but suffer no symptoms.

Types of Gallstones

Cholesterol or bile juice accounts for the two different types of stones formed in the gallbladder. The type of gallstones includes:

1. Cholesterol gallstones: This is the most common type of gallstones are characterize by yellow-greenish coloration. Undissolved cholesterol in the body forms these stones.

2. Pigment gallstones: These stones are black or dark brown and are formed from excess bilirubin in the bile.

Causes of Gallstones

How gallstones are formed is not known; however, certain conditions have been deduced to be responsible for the formation of gallstones. They include:

1. Excess cholesterol: The bile contains enough chemicals capable of dissolving cholesterol excreted by the liver. However, cholesterol stones are formed in the gallbladder when the liver produces a large amount of cholesterol than the bile can dissolve.

2. Excess bilirubin: Certain conditions such as biliary tract infection, liver cirrhosis, and certain blood disorders may cause excess production of bilirubin. Bilirubin is formed by the liver from breaking down dead red blood cells. Excess formation of bilirubin can cause the formation of gallstones.

3. Too much bile: When the gallbladder does not empty frequently, completely or regularly, it increases the concentration of the bile; this may cause the formation of stones in the bile.

Symptoms, Complications and Risk factor

Symptoms may occur in some individuals while some people are asymptomatic. Common symptoms may include:

· Intense, sudden and frequent pain in the upper right part of the abdomen

· Back pain in the shoulder blades

· Nausea and vomiting

· Discomfort

· Cramps

· Indigestion

Gallstones may cause jaundice, obstruction or blockage of the bile or pancreatic duct, inflammation of the gallbladder and in rare scenarios cancer of the gallbladder. Some individuals are more susceptible to this condition than others; certain factors such as age, gender, genetics and body composition can affect the development of gallstones. Gallstones are noticed more in female (age 40 and above), obese individuals, diabetic patients, pregnant women, people with liver disease, and in individuals who lose body weight drastically.

Treatment of Gallstones

The treatment of gallstones may vary depending on the overall health of the individual, their personal preference or recommendation by a care provider or the nature of the gallstones (size and quantity). Treatment may include:

1. Cholecystectomy: This is a surgical procedure whereby the gallbladder is removed. After this procedure, the bile flows directly to the small intestine instead of the gallbladder.

2. Medication: Patients take drugs that are capable of dissolving gallstones (oral consumption of ursodeoxycholic acid for years). However, gallstones may reoccur when the drug when the patient stops taking the medication. Gallstones can also be treated using a procedure known as extracorporeal shock wake lithotripsy only when there is a small number of gallstones; this method employs concentrating ultrasonic shock waves to break stones in the gallbladder onto tiny pieces, which are later passed in feces.

Dietary modification is best for preventing gallstones. Ensure you increase daily consumption of fresh fruits, vegetables, water, dietary fibers, and reduce consumption of saturated fats, cholesterol, and animal proteins. Maintaining a healthy weight, losing weight slowly and avoiding sedentary lifestyle can reduce the risk of developing gallstones. To learn about more important topics relating to your health visit today.

Symptoms and Signs of Stool Color Changes

Stool Color Changes Causes

Stool color can change for a variety of reasons. The change may reflect substances that are added to stool, or changes to substances normally present in stool. Some stool color changes may suggest an underlying medical condition, and others may be due to ingestion of certain foods or medications.

Black Stools (Not Sticky, No Odor)

Causes of black stool include iron pills or bismuth-containing medications (such as, bismuth subsalicylate or Pepto-Bismol). If the stool color is dark because of any of these medications, it is typically not sticky in texture and is not foul-smelling.

Black Tarry, Sticky Stools

Bleeding in the stomach (from gastritis or an ulcer) or the intestines can change the color of stool. If bleeding occurs in the stomach or the upper part of the small intestine, the stool may turn black and sticky, and be described medically as black, tarry stool (melena). Generally, black, tarry stool also is foul-smelling. This change in color and consistency occurs because of chemical reactions to blood within the intestine that are caused by digestive enzymes within the intestines.

Maroon or Red Stools

If the bleeding originates from lower parts of the intestines or the colon, blood may not come into prolonged contact with digestive enzymes because of the short distance from the site of bleeding to the rectum. Moreover, large amounts of blood within the intestines speed up transit of stool so that there is less time for the changes to take place. The stool in this type of bleeding may be dark red or maroon in color. Beets, other red vegetables, cranberries, and red food dyes also can turn the stool color red or maroon.

Gray or Clay-Colored Stool

Stool can be gray or clay-colored if it contains little or no bile. The pale color may signify a condition (biliary obstruction) where the flow of bile to the intestine is obstructed, such as obstruction of the bile duct from a tumor or gallstone in the duct or nearby pancreas. The change of stool color to gray or clay typically occurs gradually as these medical conditions progress relatively slowly and stool becomes pale over time.

Yellow Stool

Stool that is yellow may suggest presence of undigested fat in the stool.

This can occur as a result of diseases of the pancreas that reduce delivery of digestive enzymes to the intestines (pancreatic insufficiency), such as:

  • cystic fibrosis,
  • chronic pancreatitis (long standing inflammation and destruction of the pancreas usually due to alcohol abuse), or
  • obstruction of the pancreatic duct that carries the enzymes to the intestines (most commonly due to pancreatic cancer).

Celiac disease: Another condition that possibly may cause yellow and greasy stool is celiac disease (a malabsorption syndrome).

The digestive enzymes released from the pancreas and into the intestines are necessary to help digest fat and other components of food (proteins, carbohydrates) in the intestines so that they can be absorbed into the body. If the pancreas is not delivering enzymes into the intestines, then components of food, especially the fat, can remain undigested and unabsorbed. The stool containing the undigested fat may appear yellowish in color, greasy, and also may smell foul.

Ingestion of very high fat foods also can cause yellow, soft, and foul smelling stools.

Weight loss medications such as orlistat (Xenical, alli) work by limiting the amount of fat absorbed by the intestines. This can lead to bulky, yellow, and greasy stools.

Green Stool

When stool passes through the intestines rapidly (diarrhea), there may be little time for bilirubin to undergo its usual chemical changes, and stool can appear green in appearance due to rapid transit.

Eating excessive amounts of green foods, foods with green or purple dyes, and vegetables also can cause stool color to turn more green than normal.

The evaluation of changes in stool color typically begins with a thorough physical examination and personal medical history. The doctor may ask about intake of alcohol, smoking, and other habits. Family history of any cancers, particularly of the liver or pancreas, or bleeding problems may be helpful. A review of medications that may affect the color of stool, including over-the-counter (OTC) medications, also is important. Any changes in bowel habits (constipation, diarrhea, and change in frequency) or any pertinent symptoms (pain with or without eating, nausea, vomiting, weight loss, etc.) can provide clues in evaluating the underlying causes of changes in stool color.

Diagnostic testing to find the cause of changes in stool color typically start with blood tests including complete blood count (CBC),blood chemistries, liver enzymes (comprehensive metabolic panel or CMP or SMA 19), and blood clotting assays (tests of coagulation). These tests can help diagnose anemia, liver disease, gallbladder disease, or other underlying conditions that may be responsible for the changes in stool color. Pancreatic enzymes (amylase and lipase) also can be measured to determine if pancreatic disease may be present. Specific blood work for celiac disease, liver disease, and cystic fibrosis also may be evaluated if determined to be appropriate by your doctor.

If bleeding from the stomach or intestines is suspected but the stool is not visibly black, red, or maroon, then occult stool blood testing (small amount of blood that does not cause the color of stool to change much) can be done. This tests the stool directly for blood with a dye (fecal occult blood test or FOBT). Occult stool blood testing relies on a chemical reaction between a solution (called guaiac) and hemoglobin in a sample of stool. In the presence of hemoglobin, the drop of solution will turn the stool sample (smeared onto a special paper which reacts chemically with the solution) blue. This test is part of the recommendation for screening for colon cancer, although in clinical practice it is often used to determine if any bleeding is occurring in the gastrointestinal system. In addition to the test using guaiac, there is an immunological test for blood in the stool that uses an antibody to hemoglobin to detect the blood.

Methods to evaluate a change in the color of stool are upper gastrointestinal endoscopy (esophago-gastro-duodenoscopy or EGD), and colonoscopy. These tests are done by gastroenterologists to look inside the esophagus and stomach (EGD) and the colon (colonoscopy) with a video camera to detect the source of the bleeding or other abnormality that may explain the change in stool color. If necessary, biopsies can be taken with these techniques. Colonoscopy with biopsy also may aid in diagnosing conditions such as celiac disease.

More advanced endoscopic testing to look for obstruction of the biliary or pancreatic ducts is done by endoscopic retrograde cholangio-pancreatography or ERCP. This test is performed like an EGD except that during the test dye is injected into the biliary and pancreatic ducts to look with X-rays for obstruction of the ducts.

Other imaging studies sometimes are necessary in order to find the cause of the change in stool color. Computerized tomography (CT scan) is ordered frequently by physicians if the change in stool color is believed to be related to underlying cancer, pancreatic disease, or obstructive conditions of the bile ducts and gallbladder. Ultrasound of the abdomen is a frequently used and is a relatively inexpensive and reliable test to evaluate for gallstones or blockage of the gallbladder. Magnetic resonance imaging (MRI) of the abdomen sometimes is done to look more closely at any obstructive disease of the biliary or pancreatic ducts.

Obesity and Gallstones- How Are They Related?

by Jennifer Franceschelli Hosterman, DO

Spring 2017

To view a full PDF of this article, please click here.
Did you know that your weight can increase your risk for problems with your gallbladder – particularly if you have obesity? You may not think about your gallbladder when you think about your weight, but extra weight increases the risk of gallstones in your gallbladder. About 15 percent of people in the U.S. have gallstones. This means that nearly 20 million people are affected!

A study in 2013 showed that the risk of symptomatic gallstones increased 7 percent with every one point increase in Body-Mass-Index (BMI). While a majority of people with gallstones will not have symptoms, those that do may need to have their gallbladder removed surgically. Luckily, there are some ways to try to avoid this.

What Does Your Gallbladder Do, Anyway?

Your gallbladder is located in the upper right portion of your abdomen, just under your liver. The main function of the gallbladder is to store and concentrate bile – a fluid that our bodies use to digest fats and fat-soluble vitamins and then use them for energy. Bile is produced in the liver and is then secreted into the gallbladder where it is stored. When we ingest dietary fat, the gallbladder contracts and releases our bile into the small intestine via passageways called ducts. Keeping these ducts open is important to the function of the gallbladder. The gallbladder contracts to release bile every time we eat a meal that contains fats. In between meals, the gallbladder fills back up with bile to get ready for the next meal.

What Exactly Are Gallstones?

The bile that is stored in your gallbladder is composed of a delicate balance containing mostly cholesterol, bilirubin and bile salts. Too much or too little of one of these components, or a poorly emptying gallbladder, can lead to the formation of a solid cluster known as a gallstone. They can be as small as a grain of salt or as big as a golf ball, and they range in number from one large to many small stones at a time.

Many people will have gallstones and not even know it! They are often found on accident while seeing the doctor and having imaging done to evaluate something else. Gallstones aren’t usually a problem unless they start to disrupt the function of the gallbladder and surrounding organs.

You might begin to experience symptoms if they get stuck in the ducts and bile cannot get out of the gallbladder. This buildup of pressure in the gallbladder can be uncomfortable and even painful, and it’s often referred to as a gallbladder attack. Attacks are usually triggered by a fatty or heavy meal. Symptoms usually last for the time that the gallstone is blocking the duct, and they go away once the duct is no longer blocked. This can be for several minutes to several hours, but if the gallstone does not dislodge, it can cause serious side effects like infection, inflammation and dehydration.

What Does My Weight Have to Do with Gallstones?

Why does my weight matter?
Obesity – At least least 25 percent of individuals with severe obesity (BMI > 40) have evidence of gallstone disease. Where you carry this extra weight also makes a difference. Scientists believe that your risk is even higher when you carry more of this extra weight around your abdomen than in your hips and thighs.
However, adults are not the only ones affected. A study in 2012 noted that children with overweight or obesity were more likely to have gallstones compared to those who were underweight or at average weight. Obesity in the late teenage years seems to carry the highest risk.

One of the many concerns linking obesity and the gallbladder is that obesity can make it harder for the gallbladder to empty. Bile then becomes stagnant and more concentrated, which in turn increases the chances of precipitating a gallstone. Another concern is that obesity is associated with increased cholesterol production in the liver which leads to more cholesterol in the bile. This disrupts the balance of bile composition and therefore increases the risk of gallstone formation.

Rapid Weight-loss/Bariatric Surgery – Rapid weight-loss is defined as losing more than three pounds per week, and it’s also associated with an increased risk of gallstone formation. One explanation for this is the increase in mobilization of cholesterol from fat tissue during the rapid weight-loss phase. This, in turn, leads to more cholesterol in the bile – thus causing the imbalance that can lead to gallstones.

About 30 percent of people within 12-18 months after bariatric surgery will develop new gallstones. People with gallstones related to weight-loss are more likely to have symptoms compared to those without rapid weight-loss.

Low-calorie Diet or Prolonged Fasting – Nearly 10-12 percent of people on a low-calorie diet for 8-16 weeks will develop gallstones. The gallbladder contracts when we ingest fats. If you are on a very low-calorie diet or you’re fasting for a long period of time, then little (if any) fat is ingested. This is because the gallbladder doesn’t have to contract and empty itself regularly, leaving gallstones subject to form.

Weight-cycling – Repeatedly losing and gaining a significant amount of weight can also increase your risk of gallstones, but the reason is unclear. The rise in cholesterol associated with rapid weight-loss may be the culprit. Additionally, some yo-yo dieting requires prolonged fasting which is also a likely contributor.

Physical Activity – Having a more sedentary lifestyle can be associated with a higher risk of gallstones. The reason for this may have to do with the increase in weight that often occurs if we are less active.

Non weight-related Risks for Gallstones – Being over 40 or being a female can increase your risk for developing gallstones substantially. Pregnancy, family history of gallstone disease and even some medications are other factors known to increase the incidence of gallstones.

What Are the Treatment Options?

Observation – Having gallstones does not mean that you need your gallbladder removed right away. A majority of people with gallstones will never have any symptoms. In this case, people are monitored and they should be aware of potential symptoms so that they can notify their doctor if any develop.

Medical Treatment – There are medications that can help to dissolve the gallstones. These work on smaller gallstones and may take months or sometimes years to work. However, there is a chance that the stones will reoccur once the medication is stopped.

Surgical Treatment – If you are experiencing serious/chronic symptoms such as fever, vomiting, jaundice (yellowing of the eyes/skin) or low blood pressure, then your doctor may recommend that you have your gallbladder removed. This is called a cholecystectomy, and it’s often done laparoscopically (several small incisions in the abdomen instead of one larger incision).

After this procedure, most people can go home that very day. If symptoms
are more severe or the surgeon has to do an “open” cholecystectomy
(a much larger incision instead of several smaller incisions), then you may
stay overnight in the hospital for a few days to ensure a healthy recovery.

What Can You Do to Reduce Your Risk?

Maintain or Strive Toward a Healthy Weight – If you are losing weight rapidly (> 3 pounds per week) or have had weight-loss surgery, then you should talk with your doctor about your own individualized risk reduction plan. If possible, aim to make more gradual changes with a weight-loss goal of about ½ -2 pounds per week.

Avoid “Weight Cycling” – Find consistency in your healthy lifestyle changes. Make sustainable modifications to your diet and exercise plan.

Reduce or Eliminate Refined Carbohydrates – Reduce white bread, pasta and sugary drinks.

Increase Your Fiber Intake – Increase your consumption of foods like vegetables and fruits.

Become More Physically Active – The American Heart Association recommends 150 minutes of moderate physical activity per week for adults. This equates to about 30 minutes, five days per week. For children, the recommendation is 60 minutes of moderate to vigorous physical activity each day.
The good news is that many of these risk factors are modifiable. You have the power to reduce your risk!

About the Author:
Jennifer Franceschelli Hosterman, DO, is a board certified internal medicine and pediatric physician who specializes in nutrition and obesity medicine at Geisinger Medical Center. She is also the Medical Director of Camp ENERGY, which is a healthy lifestyle camp for adolescents. She earned her Bachelor’s degree in cellular and molecular biology at West Chester University and completed medical school at Philadelphia College of Osteopathic Medicine. She is a strong proponent of the multi-disciplinary and family approach in the prevention and treatment of obesity.

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