Are You at Risk for Gallstones?

Gallstones are small, pebble-like substances that form in the gallbladder, causing pain and discomfort.

The U.S. National Digestive Diseases Information Clearinghouse says risk factors for developing gallstones include:

Being a woman.  Women are twice as likely as men to develop gallstones. Excess estrogen from pregnancy, hormone replacement therapy, and birth control pills appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones.

Having a family history of gallstones. Gallstones often run in families, pointing to a possible genetic link.

Being overweight or eating a high-fat, high-cholesterol diet. A large clinical study showed that being even moderately overweight increases the risk for developing gallstones. The most likely reason is that the amount of bile salts in bile is reduced, resulting in more cholesterol. Increased cholesterol reduces gallbladder emptying. Obesity is a major risk factor for gallstones, especially in women.

Losing weight quickly. As the body metabolizes fat during prolonged fasting and rapid weight loss—such as “crash diets”—the liver secretes extra cholesterol into bile, which can cause gallstones. In addition, the gallbladder does not empty properly.

Being 60 or older. People older than age 60 are more likely to develop gallstones than younger people. As people age, the body tends to secrete more cholesterol into bile.

Being diabetic. People with diabetes generally have high levels of fatty acids called triglycerides. These fatty acids may increase the risk of gallstones.

Taking a cholesterol-lowering drug. 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 (Brozil, Ipolipid) and fenofibrate (Lipanthyl, Lexemin, Fenosup).

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Prevention of Gallstones

Diet may play a role in gallstones. The University of Maryland Medical Centre provides helpful tips here:

Fats. Although fats (particularly saturated fats found in meats, butter, and other animal products) have been associated with gallstone attacks, some studies have found a lower risk for gallstones in people who consume foods containing monounsaturated fats (found in olive and canola oils) or omega-3 fatty acids (found in canola, flaxseed, and fish oil). Fish oil may be particularly beneficial in patients with high triglyceride levels, because it improves the emptying actions of the gallbladder.

Fiber. High intake of fiber has been associated with a lower risk for gallstones.

Nuts. Studies suggest that people may be able to reduce their risk of gallstones by eating more nuts (peanuts and tree nuts, such as walnuts and almonds).

Fruits and Vegetables. People who eat a lot of fruits and vegetables may have a lower risk of developing symptomatic gallstones that require gallbladder removal.

Sugar. High intake of sugar has been associated with an increased risk for gallstones. Diets that are high in carbohydrates (such as pasta and bread) can also increase risk, because carbohydrates are converted to sugar in the body.

Alcohol. A few studies have reported a lower risk for gallstones with alcohol consumption. Even small amounts (1 ounce per day) have been found to reduce the risk of gallstones in women by 20%. Moderate intake (defined as 1 - 2 drinks a day) also appears to protect the heart. It should be noted, however, that even moderate alcohol intake increases the risk for breast cancer in women. Pregnant women, people who are unable to drink in moderation, and those with liver disease should not drink at all.

Coffee. Research suggests that drinking coffee every day can lower the risk of gallstones. The caffeine in coffee is thought to stimulate gallbladder contractions and lower the cholesterol concentrations in bile. However drinking other caffeinated beverages, such as soda and tea, does not seem to have the same benefit.

Preventing Gallstones during Weight Loss

Maintaining a normal weight and avoiding rapid weight loss are the keys to reducing the risk of gallstones. Taking the medication ursodiol (also called ursodeoxycholic acid, or Actigall) during weight loss may reduce the risk for people who are very overweight and need to lose weight quickly. This medication is ordinarily used to dissolve existing gallstones. Orlistat (Xenical), a drug for treating obesity, may protect against gallstone formation during weight loss. The drug appears to reduce bile acids and other components involved in gallstone production.