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Risk factors, treatment options and preventive measures for Gallstones

Gall stones are quite common especially in women. In most of the cases gall stone is silent meaning without any presenting symptoms, but if present right sided upper abdominal pain with radiation of the pain to the right shoulder is the most common presenting symptom.
Galls tone may not remain confined to the gall bladder but migrate to the biliary tract (common bile duct) leading to choledocolithiasis, obstruct the pancreatic duct leading to pancreatitis or may cause ascending cholangitis by causing obstruction of the biliary tract and resultant inflammatory damage.
Treatment is mainly surgical removal of the gall bladder (cholecystectomy) however drugs like ursodeoxycholic acid may dissolve the cholesterol gall stones which are not yet calcified.
Risk factors
Common risk factors associated with gall stone include
1. Increased body weight (either overweight or obese)
2. Being woman
3. Age above 40 years
4. History of multiple pregnancy: thus exposure to high level of circulating estrogen for more occasions as during pregnancy circulating estrogen level raises
5. Suffering from cirrhosis of liver
6. Suffering of inflammatory bowel diseases namely ulcerative colitis and Crohn’s disease
7. Suffering from irritable bowel disease
8. Family history of suffering from gall stone
9. Recent drastic loss of body weight either by undergoing surgical interventions especially for being morbidly obese or due to any diseases
10. Recent history of treatment with ceftriaxone
11. Taking hormonal oral contraceptive pills for long time
12. Taking hormone replacement therapy (estrogen containing)
13. Suffering from type 2 diabetes
14. Leading sedentary life style
15. Lack of exercise
16. Belonging to certain ethnic groups like being Mexican American or American Indian.
People with asymptomatic galls stones detected only during abdominal radiological investigations done to investigate other diseases, do not require any treatment other than only making them aware of the gall stone symptoms.
Treatment options for gall stone include
1. Surgical removal of the gall bladder (cholecystectomy): this surgery can be done either by opening the whole abdomen or by using the laproscope. As the gall bladder is removed the bile synthesized by the liver directly enters the digestive tract without being stored and concentrated in the gall bladder. Gall bladder is not essential to lead a healthy life and hence removal of this organ does not hamper the ability of the body to digest food.
2. Drugs: there are drugs which can dissolve gall stones especially cholesterol risk stones. However it may take months to years to dissolve the stone and only cholesterol stones are affected by these drugs. Drugs are usually prescribed in patients who cannot undergo surgery for some other reasons.
Preventive measures
There are some common measures which might prevent the occurrence of galls tone in a susceptible person. These are
1. Avoiding of meal skipping as it may increase the risk of suffering from gall stones
2. Avoiding drastic weight loss: obese or overweight persons should aim to loose weight at slower pace (about 500gm to 1 kg a week)
3. Maintaining healthy body weight by regular exercise and eating balanced healthy diet.

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