Epidemiology of Cholelithiasis

Epidemiology- the branch of medicine that deals with the incidence, distribution and possible control of diseases and other factors related to health.

According to the National Institutes of Health, as many as 20 million Americans have gallstones. One may hear the incidence of cholelithiasis in terms of the 3 F's: Female, Fat, and Forty. The reason for this alliteration can be linked to the various onset symptoms of gallstones. It should be noted, however, that while many americans have gallstones, a high percentage of them may not even be aware of them. These are called asymptomatic gallstones, and people can live their entire lives without them causing any problems.

Female:
       Obviously men can get gallstones as well, but studies have shown that women with high estrogen levels are at an increased risk for gallstones.

Fat:
      While this 'F' may not be the most politically correct, it is true that individuals who struggle with obesity is associated with an increased risk of gallstones.

Forty:
      Forty years of age tends to be the average time people who are at risk for gallstones develop them. However, according to Savitsky, a more accurate age range is between 20 and 60 years of age. Even this, however is a stretch. My surgeon discovered I had gallstones when I was 10 years old and I got my gallbladder removed when I was 14.

Other factors that are associated with an increased risk for gallbladder disease include:

• People of Native American, Mexican American and Northern European descent. 
• Inflammation of the organ
• Rapid weight loss and fasting
• High fat diets

Thankfully, treatment for cholelithiasis is relatively easy. The details of this will be elaborated on in a later blog post. Essentially, some symptoms can be controlled with diet. If the Gallbladder must come out, however, the procedure is very safe and very straight forward. The diagram below from the CDC represents this; 

Center for Disease Control Health, United States. In Brief- Medical Technology 2009. (n.d.). Retrieved September 28, 2015, from http://www.cdc.gov/nchs/data/hus/hus09_InBrief_MedicalTech.pdf

 Savitsky, D. (14). Gallstones (M. Chwistek, Ed.). 20070420. Retrieved September 9, 15, from Nursing Reference Center.

Tweed, V. (n.d.). Gallstones: HEALING FOODS & REMEDIES. Better Nutrition. Retrieved September 9, 15 from Nursing Reference Center. 

So, what is the catch with Cholelithiasis?

cho-le-li-thi-a-sis

Cholelithiasis is a disease in which concentrations of crystalized cholesterol and bilirubin salts are found in the gallbladder creating "stones." These stones vary in size and number and can either be asymptomatic or contribute to extreme discomfort in the patient.

To understand gallstones and their dietary implications, we first need to understand the anatomy and physiology of the gallbladder.

The gallbladder is tucked up under the right lobe of the liver close to the stomach, where it serves as a holding sac for bile made by the liver. Fully distended it's length is about 8 cm with about a 4 cm diameter. Recognizable by its greenish hue, the gallbladder empties (and fills) via the cystic duct, where it meets up with the common bile duct and travels to the Sphincter of Oddi, releasing its contents into the duodenum. The liver releases bile via the left and right hepatic ducts, down through the common hepatic duct, where it too joins the common bile duct to eventually empty into the duodenum. Bile is secreted and released from the liver to help emulsify fats in the small intestine. When there is excess, the bile will travel back up the hepatic duct and be stored in the gallbladder. Cholecystokinin (CCK) is the hormone that tells the gallbladder to contract, releasing its contents into the digestive system.

Medically, the gallbladder is considered non-essential, which means humans can live without it. However, patients lacking a gallbladder tend to struggle with indigestion as a result of an inability to properly digest fats.




References

 Savitsky, D. (14). Gallstones (M. Chwistek, Ed.). 20070420. Retrieved September 9, 15, from Nursing Reference Center.

Tweed, V. (n.d.). Gallstones: HEALING FOODS & REMEDIES. Better Nutrition. Retrieved September 9, 15 from Nursing Reference Center.