You thought it was acute indigestion, but gallstones?…the sharpest summer rise is in patients in their 20s to 50s
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St. Peter's Hospital 26-08-14 08:48Main content
If you have ever had sudden severe abdominal pain and indigestion that cleared up within a few hours, it is best not to dismiss it as simple gastritis or dyspepsia. If such symptoms appeared while you were dieting in summer, or if the pain came on after eating greasy food, it is worth suspecting gallstone disease.
Gallstone disease is heavily weighted toward older people, with more than half of all patients aged 60 and over. Recently, however, the total number of patients has been rising steadily, so younger age groups also need to take care.
According to Health Insurance Review and Assessment Service data, the number of patients treated for gallstone disease in Korea rose from 192,551 in 2018 to more than 200,000 for the first time in 2019, reaching about 286,700 in 2025 — an increase of about 49% over seven years.
Gallstone disease has recently been rising among patients in their 20s to 50s in summer in particular. An analysis of the average monthly increase in patients in July and August compared with June over the past three years found a rise of 8.4% among those in their 20s and 30s and 9.4% among those in their 40s and 50s. Compared with the average increase of 5.6% among patients aged 60 and over over the same period, these figures are 1.5 and 1.7 times higher respectively.
Park Kwan-tae, Director of General Surgery at the Hepatobiliary-Pancreatic & Vascular Center of St. Peter's Hospital, explained, "Gallstone disease is influenced by a variety of factors such as obesity, eating habits and rapid weight loss," adding, "In summer especially, short-term dieting, irregular meals and excessive dietary restriction all increase, so the risk of gallstone disease in younger people can rise as well."
Crash weight loss and extreme diets raise gallstone risk
Gallstone disease is a condition in which sediment in the bile precipitates and clumps into stones in the gallbladder or bile duct. The liver produces about 750 ml of bile a day, made up of cholesterol, fat, bile salts, protein and bilirubin. When the proportions of these components become unbalanced, sediment can form inside the gallbladder and gallstones can develop.
The most common type is the cholesterol stone, which forms when there is too much cholesterol in the bile. Because it is linked to obesity and a diet centered on meat and high fat, younger people cannot be complacent either. The female hormone estrogen can also raise cholesterol levels in the bile, so women need to be especially careful.
Director Park Kwan-tae pointed out, “Rapid weight loss over a short period and severe food restriction can weaken gallbladder function and create conditions in which gallstones form easily.”
Rapid weight loss using GLP-1 drugs, whose use has been increasing recently, is also being found to be associated with a higher risk of gallbladder disease, including gallstone disease. Extreme fasting or very low-fat, very low-calorie diets can likewise reduce contraction of the gallbladder and create conditions in which bile easily stagnates.
To prevent gallstones from forming, exercise regularly and keep to healthy eating habits. Avoid going without food for long periods or restricting your diet to extremes in order to lose weight in summer, and allow enough time to reduce your weight gradually. People with a family history of gallstone disease, those who are obese and middle-aged and older adults need to take particular care with their lifestyle.
Checking the condition of the liver and gallbladder regularly is also important. Most gallstones cause no particular symptoms, so they are often found incidentally on abdominal ultrasound during a health screening.
Director Park said, "Not every gallstone needs treatment, but checking and managing the location and size of the stones and whether there are symptoms in advance helps to gauge the risk of complications such as cholecystitis, cholangitis and pancreatitis."
Marked by sudden 'biliary colic'…easily mistaken for indigestion or gastritis
When a gallstone blocks the flow of bile in the gallbladder or bile duct, various symptoms such as abdominal pain and nausea can appear. The typical symptom is biliary colic, which occurs mainly in the upper abdomen and the right upper quadrant. It is pain caused by rising pressure inside the gallbladder as a stone blocks the cystic duct, and it is easily mistaken for indigestion, gastritis or dyspepsia.
Biliary colic characteristically begins suddenly with severe pain that lasts from as little as 30 minutes to as long as several hours. Nausea or vomiting may accompany the abdominal pain, and if the pain recurs after overeating or eating greasy, high-fat food, biliary colic is a possibility.
If the pain lasts more than five to six hours or is accompanied by fever, there is a risk of complications such as acute cholecystitis, so seek medical care as soon as possible.
The most basic test for diagnosing gallstone disease is abdominal ultrasound, which can confirm the presence of gallstones in more than 90% of cases. Where necessary, CT or magnetic resonance cholangiopancreatography (MRCP) is performed to examine the condition of the bile duct and pancreatic duct. On the basis of the results, the location and size of the stones and the presence of inflammation are confirmed and the direction of treatment is decided.
Even when gallstones are present, if there are no symptoms and the risk of gallbladder cancer or complications is not high, the patient may simply be monitored without treatment. If the stones cause pain, or if the risk of complications is high even without symptoms, surgical treatment is performed at the specialist's discretion.
In particular, when the stones are 3 cm or larger, or when a calcified 'porcelain' gallbladder, gallbladder polyps or pancreaticobiliary maljunction are also present, prophylactic cholecystectomy may be considered even in the absence of symptoms.
The standard surgical treatment is cholecystectomy. Laparoscopic surgery is now mainly used; the incision is small and recovery is quick, so depending on the patient's condition discharge may be possible one to two days after surgery. However, depending on the location and state of the stones, the liver and pancreas may also need to be examined and further treatment may be required, so anyone who suspects gallstone disease should be seen by a specialist in hepatobiliary-pancreatic surgery.
Some patients with pure cholesterol stones smaller than 1.5 cm and preserved gallbladder function can be treated with ursodeoxycholic acid (UDCA), which reduces the cholesterol in the bile and dissolves the stones. Because the recurrence rate can reach 50% once the medication is stopped, however, a treatment plan should be drawn up after a thorough consultation with a specialist.
Director Park Kwan-tae stressed, "Even among patients without symptoms, about 1-2% a year are known to develop symptoms such as pain, so continued follow-up and management are important," adding, "Avoid the lifestyle habits that raise the risk of gallstones, and if sudden abdominal pain or digestive symptoms recur, see a specialist for an accurate diagnosis."
Source: Health Digest (https://www.ikunkang.com)
Gallstone disease is heavily weighted toward older people, with more than half of all patients aged 60 and over. Recently, however, the total number of patients has been rising steadily, so younger age groups also need to take care.
According to Health Insurance Review and Assessment Service data, the number of patients treated for gallstone disease in Korea rose from 192,551 in 2018 to more than 200,000 for the first time in 2019, reaching about 286,700 in 2025 — an increase of about 49% over seven years.
Gallstone disease has recently been rising among patients in their 20s to 50s in summer in particular. An analysis of the average monthly increase in patients in July and August compared with June over the past three years found a rise of 8.4% among those in their 20s and 30s and 9.4% among those in their 40s and 50s. Compared with the average increase of 5.6% among patients aged 60 and over over the same period, these figures are 1.5 and 1.7 times higher respectively.
Park Kwan-tae, Director of General Surgery at the Hepatobiliary-Pancreatic & Vascular Center of St. Peter's Hospital, explained, "Gallstone disease is influenced by a variety of factors such as obesity, eating habits and rapid weight loss," adding, "In summer especially, short-term dieting, irregular meals and excessive dietary restriction all increase, so the risk of gallstone disease in younger people can rise as well."
Crash weight loss and extreme diets raise gallstone risk
Gallstone disease is a condition in which sediment in the bile precipitates and clumps into stones in the gallbladder or bile duct. The liver produces about 750 ml of bile a day, made up of cholesterol, fat, bile salts, protein and bilirubin. When the proportions of these components become unbalanced, sediment can form inside the gallbladder and gallstones can develop.
The most common type is the cholesterol stone, which forms when there is too much cholesterol in the bile. Because it is linked to obesity and a diet centered on meat and high fat, younger people cannot be complacent either. The female hormone estrogen can also raise cholesterol levels in the bile, so women need to be especially careful.
Director Park Kwan-tae pointed out, “Rapid weight loss over a short period and severe food restriction can weaken gallbladder function and create conditions in which gallstones form easily.”
Rapid weight loss using GLP-1 drugs, whose use has been increasing recently, is also being found to be associated with a higher risk of gallbladder disease, including gallstone disease. Extreme fasting or very low-fat, very low-calorie diets can likewise reduce contraction of the gallbladder and create conditions in which bile easily stagnates.
To prevent gallstones from forming, exercise regularly and keep to healthy eating habits. Avoid going without food for long periods or restricting your diet to extremes in order to lose weight in summer, and allow enough time to reduce your weight gradually. People with a family history of gallstone disease, those who are obese and middle-aged and older adults need to take particular care with their lifestyle.
Checking the condition of the liver and gallbladder regularly is also important. Most gallstones cause no particular symptoms, so they are often found incidentally on abdominal ultrasound during a health screening.
Director Park said, "Not every gallstone needs treatment, but checking and managing the location and size of the stones and whether there are symptoms in advance helps to gauge the risk of complications such as cholecystitis, cholangitis and pancreatitis."
Marked by sudden 'biliary colic'…easily mistaken for indigestion or gastritis
When a gallstone blocks the flow of bile in the gallbladder or bile duct, various symptoms such as abdominal pain and nausea can appear. The typical symptom is biliary colic, which occurs mainly in the upper abdomen and the right upper quadrant. It is pain caused by rising pressure inside the gallbladder as a stone blocks the cystic duct, and it is easily mistaken for indigestion, gastritis or dyspepsia.
Biliary colic characteristically begins suddenly with severe pain that lasts from as little as 30 minutes to as long as several hours. Nausea or vomiting may accompany the abdominal pain, and if the pain recurs after overeating or eating greasy, high-fat food, biliary colic is a possibility.
If the pain lasts more than five to six hours or is accompanied by fever, there is a risk of complications such as acute cholecystitis, so seek medical care as soon as possible.
The most basic test for diagnosing gallstone disease is abdominal ultrasound, which can confirm the presence of gallstones in more than 90% of cases. Where necessary, CT or magnetic resonance cholangiopancreatography (MRCP) is performed to examine the condition of the bile duct and pancreatic duct. On the basis of the results, the location and size of the stones and the presence of inflammation are confirmed and the direction of treatment is decided.
Even when gallstones are present, if there are no symptoms and the risk of gallbladder cancer or complications is not high, the patient may simply be monitored without treatment. If the stones cause pain, or if the risk of complications is high even without symptoms, surgical treatment is performed at the specialist's discretion.
In particular, when the stones are 3 cm or larger, or when a calcified 'porcelain' gallbladder, gallbladder polyps or pancreaticobiliary maljunction are also present, prophylactic cholecystectomy may be considered even in the absence of symptoms.
The standard surgical treatment is cholecystectomy. Laparoscopic surgery is now mainly used; the incision is small and recovery is quick, so depending on the patient's condition discharge may be possible one to two days after surgery. However, depending on the location and state of the stones, the liver and pancreas may also need to be examined and further treatment may be required, so anyone who suspects gallstone disease should be seen by a specialist in hepatobiliary-pancreatic surgery.
Some patients with pure cholesterol stones smaller than 1.5 cm and preserved gallbladder function can be treated with ursodeoxycholic acid (UDCA), which reduces the cholesterol in the bile and dissolves the stones. Because the recurrence rate can reach 50% once the medication is stopped, however, a treatment plan should be drawn up after a thorough consultation with a specialist.
Director Park Kwan-tae stressed, "Even among patients without symptoms, about 1-2% a year are known to develop symptoms such as pain, so continued follow-up and management are important," adding, "Avoid the lifestyle habits that raise the risk of gallstones, and if sudden abdominal pain or digestive symptoms recur, see a specialist for an accurate diagnosis."
Source: Health Digest (https://www.ikunkang.com)