Thought it was indigestion…beware ‘young-onset gallstones’ in summer
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St. Peter's Hospital 26-08-14 10:00Main content
[Uihaksinmun · Ilgan Bosa] If you have suffered sudden severe abdominal pain or indigestion and then felt fine again within a few hours, it should not simply be put down to gastritis or indigestion. In particular, if similar pain recurs while dieting in summer or after eating fatty food, 'gallstone disease' needs to be suspected.
Gallstone disease is known to occur mainly in older adults, but the number of patients in younger age groups has been rising recently. According to the Health Insurance Review and Assessment Service, gallstone patients increased from 192,551 in 2018 to about 286,700 in 2025, a rise of roughly 49% in seven years.
In particular, over the past three years the average monthly increase in patients in July and August compared with June was 8.4% among people in their 20s and 30s and 9.4% among those in their 40s and 50s. That is 1.5 and 1.7 times the 5.6% increase among people aged 60 and over during the same period.
Gallstone disease is a condition in which components of the bile settle out and harden into stones in the gallbladder or bile ducts. Bile produced by the liver consists of cholesterol, fats, bile salts, protein and bilirubin, and gallstones can form when the balance among these components breaks down.
The most common form is the cholesterol gallstone, which develops as cholesterol in the bile increases. Along with obesity and a diet based on meat and high-fat food, dieting that sheds a lot of weight in a short period and long spells of fasting can also raise the risk.
Sustained extreme fasting or a very-low-calorie diet keeps the gallbladder from contracting fully, making it easier for bile to stagnate. Rapid weight loss with GLP-1 drugs, whose use has increased recently, is also known to be linked to a higher risk of gallbladder disease, so caution is needed.
Women are also at relatively higher risk, because estrogen, the female hormone, can raise the concentration of cholesterol in the bile. People with a family history of gallstone disease, those who are obese and middle-aged and older adults likewise need to pay closer attention to managing their lifestyle.
Sudden abdominal pain lasting from 30 minutes to several hours: suspect ‘biliary colic’
The characteristic symptom of gallstone disease is 'biliary colic', which comes on suddenly in the upper abdomen or the right upper abdomen. The pain arises as a stone blocks the cystic duct and pressure inside the gallbladder rises, and it is easily mistaken for indigestion, gastritis or simple dyspepsia.
Unlike gastritis, in which heartburn persists, biliary colic brings severe pain on suddenly, lasting anywhere from 30 minutes to several hours. It may appear together with nausea or vomiting, and often recurs after overeating or eating fatty food.
If the pain lasts more than 5–6 hours or is accompanied by fever, the possibility of complications such as acute cholecystitis must be considered. It can also progress to cholangitis or pancreatitis, in which case medical attention should be sought as soon as possible.
Abdominal ultrasound is the most basic tool used for diagnosis. Most gallstones can be identified with ultrasound, and CT or magnetic resonance cholangiopancreatography (MRCP) is added when necessary to check the location and size of the stones, the state of the bile and pancreatic ducts and the presence of inflammation.
Not every gallstone has to be treated. If there are no particular symptoms and the risk of gallbladder cancer or complications is low, the condition can simply be monitored with regular check-ups. Surgery may be considered, however, when there is pain, when the stones are 3cm or larger, or when the risk of complications is high, as with a porcelain gallbladder or gallbladder polyps.
The standard operation is laparoscopic cholecystectomy. The incision is relatively small and recovery is quick, and depending on the patient's condition discharge can come within 1–2 days after surgery. In a very small number of cases, drug therapy may be given after considering gallbladder function and the composition and size of the stones, but recurrence is possible, so a specialist's judgement is needed.
For prevention, it is important to avoid extreme fasting and rapid weight loss and to manage weight slowly through regular meals and exercise. Because gallstones are often found by chance at a health screening without any symptoms, checking the state of the gallbladder with abdominal ultrasound is also helpful for anyone with risk factors such as a family history or obesity.
If sudden upper abdominal pain or vomiting keeps recurring while dieting, or similar symptoms often appear after a fatty meal, do not dismiss it as simple indigestion. It is important to establish exactly how the symptoms present and where the stones are and how large they are, and then to receive appropriate treatment and follow-up care.
Source: Medical Newspaper (https://www.bosa.co.kr)
Gallstone disease is known to occur mainly in older adults, but the number of patients in younger age groups has been rising recently. According to the Health Insurance Review and Assessment Service, gallstone patients increased from 192,551 in 2018 to about 286,700 in 2025, a rise of roughly 49% in seven years.
In particular, over the past three years the average monthly increase in patients in July and August compared with June was 8.4% among people in their 20s and 30s and 9.4% among those in their 40s and 50s. That is 1.5 and 1.7 times the 5.6% increase among people aged 60 and over during the same period.
Gallstone disease is a condition in which components of the bile settle out and harden into stones in the gallbladder or bile ducts. Bile produced by the liver consists of cholesterol, fats, bile salts, protein and bilirubin, and gallstones can form when the balance among these components breaks down.
The most common form is the cholesterol gallstone, which develops as cholesterol in the bile increases. Along with obesity and a diet based on meat and high-fat food, dieting that sheds a lot of weight in a short period and long spells of fasting can also raise the risk.
Sustained extreme fasting or a very-low-calorie diet keeps the gallbladder from contracting fully, making it easier for bile to stagnate. Rapid weight loss with GLP-1 drugs, whose use has increased recently, is also known to be linked to a higher risk of gallbladder disease, so caution is needed.
Women are also at relatively higher risk, because estrogen, the female hormone, can raise the concentration of cholesterol in the bile. People with a family history of gallstone disease, those who are obese and middle-aged and older adults likewise need to pay closer attention to managing their lifestyle.
Sudden abdominal pain lasting from 30 minutes to several hours: suspect ‘biliary colic’
The characteristic symptom of gallstone disease is 'biliary colic', which comes on suddenly in the upper abdomen or the right upper abdomen. The pain arises as a stone blocks the cystic duct and pressure inside the gallbladder rises, and it is easily mistaken for indigestion, gastritis or simple dyspepsia.
Unlike gastritis, in which heartburn persists, biliary colic brings severe pain on suddenly, lasting anywhere from 30 minutes to several hours. It may appear together with nausea or vomiting, and often recurs after overeating or eating fatty food.
If the pain lasts more than 5–6 hours or is accompanied by fever, the possibility of complications such as acute cholecystitis must be considered. It can also progress to cholangitis or pancreatitis, in which case medical attention should be sought as soon as possible.
Abdominal ultrasound is the most basic tool used for diagnosis. Most gallstones can be identified with ultrasound, and CT or magnetic resonance cholangiopancreatography (MRCP) is added when necessary to check the location and size of the stones, the state of the bile and pancreatic ducts and the presence of inflammation.
Not every gallstone has to be treated. If there are no particular symptoms and the risk of gallbladder cancer or complications is low, the condition can simply be monitored with regular check-ups. Surgery may be considered, however, when there is pain, when the stones are 3cm or larger, or when the risk of complications is high, as with a porcelain gallbladder or gallbladder polyps.
The standard operation is laparoscopic cholecystectomy. The incision is relatively small and recovery is quick, and depending on the patient's condition discharge can come within 1–2 days after surgery. In a very small number of cases, drug therapy may be given after considering gallbladder function and the composition and size of the stones, but recurrence is possible, so a specialist's judgement is needed.
For prevention, it is important to avoid extreme fasting and rapid weight loss and to manage weight slowly through regular meals and exercise. Because gallstones are often found by chance at a health screening without any symptoms, checking the state of the gallbladder with abdominal ultrasound is also helpful for anyone with risk factors such as a family history or obesity.
If sudden upper abdominal pain or vomiting keeps recurring while dieting, or similar symptoms often appear after a fatty meal, do not dismiss it as simple indigestion. It is important to establish exactly how the symptoms present and where the stones are and how large they are, and then to receive appropriate treatment and follow-up care.
Source: Medical Newspaper (https://www.bosa.co.kr)