Asked by Jessie, North Carolina
My mom, grandma and older sister have all had their gallbladders removed. For the past month, I have been getting nauseated and/or experiencing pain in my upper belly after many meals. It seems as though I can tolerate little of any type of fat. The only thing that makes my discomfort manageable is Mylanta and Zantac. Are my symptoms and family history indicative of gallbladder problems? My doctor didn't immediately think so.
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
I encourage you to keep working with your doctor to find the cause and solution for your problem. Your symptoms could be consistent with gallbladder disease, but might be more consistent with gastric ulcer disease or acid reflux.
Gallstone disease is one of the most common diseases among adults. In the U.S., it is estimated that more than 18 million people have the disease. Gallbladder disease is more common in the obese.
It is twice as common in women -- especially women who have had multiple childbirths. Most with gallstone disease are over the age of 40.
Gallstones are hard masses of cholesterol or bile accumulating in the gallbladder. The gallbladder is just below the liver and above the pancreas. It stores bile juices secreted from the liver and used in the process of digesting food.
Gallstone disease is most often asymptomatic, but can cause pain in the middle and right upper abdomen. Many only have mild to moderate discomfort for an hour or so after consuming a meal high in fat. For others, this discomfort can be severe pain. This condition is called biliary colic.
There is very little that can be done to quickly relieve a painful attack with the exception of pain medicines. It is not uncommon for people to mistakenly attribute relief to taking an antacid or other drug because the pain generally abates about an hour or so after it starts.
Stones in the gallbladder over a long period of time can cause a thickening and hardening of the gallbladder, which is referred to as chronic cholecystitis. The gallbladder with stones in it can get inflamed and infected, and this can lead to acute cholecystitis.
The pain of acute cholecystitis is usually steady and severe and may radiate to the right shoulder or back. It usually does not go away for hours. Associated complaints may include nausea, vomiting and loss of appetite. Cholecystitis, whether acute or chronic, is usually treated with a surgery to remove the gallbladder.
Gallstone disease is most commonly diagnosed when a patient with some of the symptoms above receives an ultrasound of the right upper quadrant of the abdomen (the liver, pancreas and biliary tree). Some patients will also get a computerized tomogram (CT scan) or a magnetic resonance imaging study (MRI) of the upper abdomen.
In addition to obesity, gender, fertility and age, there are a number of factors that correlate with risk. Some common dietary factors in addition to common genetic or familial factors that travel with ethnicity may increase risk. There are higher rates in Western Caucasian, Hispanic and Native American populations, compared with Eastern European, African-American and Japanese populations.
There are a number of other risk factors. In addition to a history of multiple pregnancies and oral contraceptive use, estrogen replacement therapy and progesterone therapy are factors. Diabetes and obesity -- especially morbid obesity -- increase risk. Rapid weight loss also raises risk.
There are some things that are correlated with a lower risk of gallstone disease and may actually lower the risk of gallstone formation. Physically active people appear to be at lower risk, and there are studies to suggest that people who take statin drugs to treat high cholesterol levels have lower risk.
Other factors that are correlated with a lower risk of gallstone disease are a low-fat diet, a diet high in vitamin C and moderate coffee consumption.
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