Health Conditions

Women More at Risk for Gallstones—How to Avoid an Attack

Margaret wasn’t feeling well. She was nauseated, with cold chills and sweating. She figured she must have gotten the flu, but then there was the pain between her shoulder blades. She didn’t think it was muscle pain, as she hadn’t done any heavy lifting lately, and besides, it felt a little different than typical muscle pain, more internal, somehow.

She waited for a few hours, but the symptoms didn’t go away. In fact, they got worse, especially the pain. That evening, Margaret went to the emergency room, where she was diagnosed as having a gallbladder attack. She was scheduled for surgery immediately.

Women are more at risk for gallbladder problems and gallstones than men are, and women of Mexican or American Indian heritage are even more at risk. It’s probably not something you’ve thought about very often, but you may want to start. There are steps you can take to reduce your risk of suffering an attack like Margaret did.

What is the Gallbladder?

The gallbladder is a small pouch that sits just underneath the liver, where it stores the bile that the liver produces until the body needs it. Bile helps the body break down and digest fats. When you eat a meal, hormones in the small intestine inspire the gallbladder to release that stored bile into the small intestine through tubes called “bile ducts.” There, it works to break down the fats from your meal, so the small intestine can absorb and use them.

In the early stages, for example, gallbladder pain flares up now and then. This usually occurs after you eat fatty foods, like fried foods, meat, and full-fat dairy. You may also experience digestive issues, like stomach pain, diarrhea, or indigestion.

When trying to locate your gallbladder, think of the upper right quadrant of the abdomen, just under the ribs. This is likely where you would experience pain, should you go through a gallbladder attack. The pain can also radiate into the back in about the same area, which is why Margaret suffered from pain between the shoulder blades.

What are Gallstones?

Gallstones are the most common disorder of the gallbladder, and occur when the components of bile crystallize and harden. It’s most often the cholesterol in the bile that makes up the stones, but sometimes it’s the calcium salts and bilirubin (an orange-yellow pigment formed in the liver).

These components may solidify into stones of various sizes. Small ones aren’t likely to cause any problems, but larger ones can sometimes block the exit from the gallbladder, causing spasms and inflammation. When this happens, you usually experience some of the symptoms of a gallbladder attack, but the episode may go away on its own. Other times, as in Margaret’s case, the situation gets more serious, the inflammation gets worse, and the gallbladder can become infected.

What Causes Gallstones?

Scientists aren’t sure yet what causes gallstones to form, but they suspect that in most cases, it’s because of an excess of cholesterol in the bile. Gallstones are also more common in people with liver disease and sickle-cell anemia.

Below are several other factors that can increase your risk:

  • Gender—about twice as many women as men get gallstones
  • Excess fat around the middle—a 2006 study showed that women with waists of 36 inches or more were almost twice as likely to require surgery to remove gallstones as those whose waists measured 26 inches or less
  • Overweight or obese
  • Pregnancy
  • Birth control pills
  • Family history of gallstones
  • High-fat diet
  • Age 60 or older
  • American descent
  • Diabetes
  • Hormone replacement therapy (HRT)

What are the Symptoms of a Gallbladder Attack?

Most gallstones remain in the gallbladder and don’t create any problems. When they do disrupt the flow of bile, they can cause inflammation and other symptoms, including nausea and vomiting, sweating, restlessness, and pain on the right side of the body below the ribs where the gallbladder rests. Pain may also show up in the back or in the right shoulder.

In more rare cases, should the gallstone pass through the bile duct into the first part of the small intestine, it can cause what is called “biliary colic.” This condition shows up as pain in the upper part of the abdomen, usually about an hour after eating a high-fat meal. The pain my last a few hours, and then fade away.

In more rare cases, should the gallstone pass through the bile duct into the first part of the small intestine, it can cause what is called “biliary colic.” This condition shows up as pain in the upper part of the abdomen, usually about an hour after eating a high-fat meal. The pain my last a few hours, and then fade away.

If the gallstone causes an infection, you may also suffer from fever and chills, and if the stone gets stuck in the bile duct, it could cause jaundice, a serious condition that causes yellow-skin.

In the early stages, for example, gallbladder pain flares up now and then. This usually occurs after you eat fatty foods, like fried foods, meat, and full-fat dairy. You may also experience digestive issues, like stomach pain, diarrhea, or indigestion.

In the early stages, for example, gallbladder pain flares up now and then. This usually occurs after you eat fatty foods, like fried foods, meat, and full-fat dairy. You may also experience digestive issues, like stomach pain, diarrhea, or indigestion.

If you take note of these early stages, you can make lifestyle changes that may prevent a full-on gallbladder attack down the road. If such an attack does occur, it means the gallstone has blocked the exit, and this constitutes a medical emergency. You will experience intense pain, and possibly fever, chills, and appetite loss.

Fortunately, incidences of gallbladder attacks are low. The American College of Gastroenterology states that the risk of so-called “silent” gallstones causing an attack is about one percent annually.

What Should I Do During a Gallbladder Attack?

It can be difficult sometimes to tell if you need to go to the doctor or not. Most of the time, you can use your intuition. If you notice symptoms that worry you, go ahead and make the appointment. It’s always better to be safe than sorry.

If you experience some of the more serious symptoms listed above, such as fever and chills or yellowing skin, get to the emergency room right away, as these are symptoms of a gallstone complication, and you don’t want to wait to get them treated. Also, if you experience intense pain for more than an hour or two, go to the doctor’s office or emergency room immediately.

If you experience some of the more serious symptoms listed above, such as fever and chills or yellowing skin, get to the emergency room right away, as these are symptoms of a gallstone complication, and you don’t want to wait to get them treated. Also, if you experience intense pain for more than an hour or two, go to the doctor’s office or emergency room immediately.

To make a diagnosis, the doctor may recommend an abdominal ultrasound and/or a CT scan to see images of the gallbladder. Looking at these, he may notice signs of gallstones. In rare cases, a “cholangiography” is also used, which is a test that employs a dye to highlight any problems. A blood test may show signs of infection.

Treatment is recommended only if the gallbladder is inflamed, the bile ducts are blocked, or if the gallstones have moved into the intestines.

How are Gallstones Treated?

If your symptoms are mild, or the stones are small, doctors can sometimes dissolve them with a medication. It takes time, though, usually 6-12 months for the drugs to actually dissolve the stones.

In most other cases, doctors will opt to remove the gallbladder in a surgical procedure. The classic treatment involves making an incision in the abdomen, and taking the gallbladder out. Most people function just fine without it, though doctors usually advise a low-fat diet.

A more minimally invasive option is also available, in which the surgeon removes the gallbladder through a laparoscope, which requires a smaller incision.

10 Ways to Reduce Your Risk of a Gallbladder Attack

If you noticed yourself in any of the risk factors above—and if you’re a woman, you did!—you should consider taking steps to reduce your risk of gallstone-related complications. Some of the most important things you can do include:

  1. Eat a low-fat diet. Cut back on high-fat, greasy, and fried foods, and choose low-fat options. Avoid full-fat butter, cream, hard cheeses, cakes, meats, and processed meats. Include more fruits and vegetables, lean meats and proteins, and whole grains.
  2. Add more fiber to your diet. Research has shown that a diet high in fiber helps reduce risk of gallstone formation. One 2004 study reported that consuming more fiber helped women decrease risk of gallbladder surgery. Scientists expect the reason is that fiber helps decrease bile cholesterol levels. Good sources include vegetables, wheat, and whole grains, including whole-grain cereals.
  3. Eat a lowcholesterol diet. Since excess cholesterol makes up most gallstones, cutting back on your cholesterol may help.
  4. Exercise every day. A 2008 study found that participants who exercised regularly got far fewer gallstones than those who were sedentary. Go for 30-45 minutes of brisk walking each day of the week.
  5. Eat a hearthealthy diet: A recent meta-analysis showed that a history of gallstone disease was linked to a 23 percent increased risk of developing coronary heart disease. Researchers stated that preventing gallstone disease benefits heart health. Eat a heart-healthy diet and get regular exercise.
  6. Maintain a healthy weight. If you’ve gained weight, try to lose some. Even five pounds can make a difference. Don’t go on a crash diet, though—rapid weight loss is also linked to a higher risk of gallstones.
  7. Take a vitamin C supplement. A 2009 study found that regular vitamin C supplementation was associated with a reduced prevalence of gallstones.
  8. Snack on nuts. A 2004 study reported that consumption of peanuts and other nuts was associated with a lower risk of gallstones. Just don’t eat too many—a single handful is an appropriate serving.
  9. Enjoy your cup of coffee. A 2000 study indicated that among women previously diagnosed with gallbladder disease, increased coffee drinking seemed to have a protective effect.
  10. Get enough magnesium. Research has found that being deficient in magnesium can raise your risk of gallstones. Eat more fruits, vegetables, and nuts, and consider a daily supplement.

Sources

“A bulging midriff roughly doubles women’s chances of gallstone surgery,” BMJ Specialty Journals, [Press Release], February 13, 2006, https://www.eurekalert.org/pub_releases/2006-02/bsj-abm021006.php.

“Gallstones in Women,” American College of Gastroenterology, http://patients.gi.org/topics/gallstones-in-women/.

Yan Zheng, et al., “Gallstones and Risk of Coronary Heart Disease,” Arteriosclerosis, Thrombosis, and Vascular Biology, 2016; 36:1997-2003, http://atvb.ahajournals.org/content/36/9/1997.

Thomas Walcher, et al., “Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population,” BMC Gastroenterol., 2009; 9:74, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763865/.

Constance E. Ruhl, James E. Everhart, “Association of Coffee Consumption with Gallbladder Disease,” Am J Epidemiol., 2000; 152(11):1034-1038, https://academic.oup.com/aje/article/152/11/1034/124241/Association-of-Coffee-Consumption-with-Gallbladder.

Ghung-Jyi Tsai, et al., “A Prospective Cohort Study of Nut Consumption and the Risk of Gallstone Disease in Men,” American Journal of Epidemiology, 2004; 160(10):961-968.

Giovanni Misciagna, et al., “Diet, physical activity, and gallstones—a population-based, case-control study in southern Italy,” American Journal of Clinical Nutrition, January 1999; 69(1):120-126, http://ajcn.nutrition.org/content/69/1/120.full.

“Fiber May Reduce the Need for Gallbladder Surgery,” Bad Gut, 2004; http://www.badgut.org/information-centre/a-z-digestive-topics/fiber-may-reduce-the-need-for-gallbladder-surgery/.

Dr. Blaylock, “Magnesium Can Prevent Gallstones,” Newsmax, April 5, 2016, http://www.newsmax.com/Health/Dr-Blaylock/gallstones-magnesium-nuts-obesity/2016/04/05/id/722420/.

Wilund KR, et al., “Endurance exercise training reduces gallstone development in mice,” J Appl Physiol., March 2008; 104(3):761-5, https://www.ncbi.nlm.nih.gov/pubmed/18187606.

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Colleen M. Story

Colleen M. Story

Colleen M. Story is a full-time freelance writer and editor, author, and musician committed to helping people take control of their own health and well-being. She is the founder of Writing and Wellness, and has two novels forthcoming from Jupiter Gardens Press (“Rise of the Sidenah”) and Dzanc Books (“Loreena’s Gift”). Find more info at colleenmstory.com.

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