GALLSTONES
Gallstones form in the gallbladder when there is an excessive increase in the concentration of cholesterol in bile. (Bile is a secretion of the liver that aids in fat emulsification.) In the United States, 20 percent of women and 10 percent of men have cholesterol gallstones by age sixty-five. Less common are pigment stones, which form when bilirubin, a bile pigment, precipitates in bile following an increase in the breakdown of red blood cells, as in sickle cell anemia. Risk factors for cholesterol gallstones include heredity (Native Americans are at increased risk), obesity, rapid weight loss, physical inactivity, pregnancy, and diabetes. Episodic abdominal pain (biliary colic) or inflammation of the gallbladder (cholecystitis) occur in 25 percent of persons with gallstones. A stone may pass from the gallbladder and block the bile duct or cause pancreatitis. Symptomatic stones are generally treated by surgical removal of the gall bladder (cholecystectomy) or, occasionally, chemical dissolution of the stones by oral administration of bile acids.
LAWRENCE S. FRIEDMAN
(SEE ALSO: Cholesterol Test; Nutrition; Physical Activity; Sickle Cell Disease)
BIBLIOGRAPHY
Bilhartz, L. E., and Horton, J. D. (1998). "Gallstone Disease and Its Complications." In Sleisinger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management, 6th edition, eds. M. Feldman, B. F. Scharschmidt, and M. H. Sleisinger. Philadelphia, PA: Saunders.
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