St. Peter's Hospital: “You think it is summer indigestion…but watch out for gallstones”
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St. Peter's Hospital 26-08-14 11:21Main content
If you have experienced sudden indigestion and severe abdominal pain that eased within a few hours, do not put it down to simple gastritis — 'gallstone disease' should be suspected. Gallstone disease is a condition in which an imbalance in the components of bile creates sediment that hardens into stones in the gallbladder or bile ducts. The liver produces about 750mL of bile a day, made up of cholesterol, fats, bile salts, protein and bilirubin.
According to Health Insurance Review and Assessment Service data released on the 14th, gallstone disease largely affects people aged 60 and over, but in summer the increase in patients in their 20s to 50s stands out. Over the past three years, the average 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 — 1.5 and 1.7 times the 5.6% increase among people in their 60s.
Experts point to summer lifestyle habits as one of the causes. Park Kwan-tae, general surgery specialist and Director of the Hepatobiliary-Pancreatic & Vascular Center at St. Peter's Hospital, explained, “Gallstone disease is influenced by a range of factors, including obesity, eating habits and rapid weight loss.” He added, “In summer in particular, short-term dieting, irregular meals and extreme dietary restriction all increase, so the risk of gallstone disease rises among younger people.”
Abrupt fasting and very-low-fat, very-low-calorie diets in particular weaken the gallbladder's ability to contract, creating conditions in which bile easily stagnates. Caution is also needed when a large amount of weight is lost in a short period using the GLP-1 obesity drugs now spreading rapidly. In addition, because estrogen, the female hormone, raises cholesterol levels in the bile, women need to be especially careful.
If a gallstone blocks the cystic duct or the bile duct, sudden severe pain can appear in the upper abdomen or the right upper abdomen. The pain lasts from as little as 30 minutes to as long as several hours, may be accompanied by nausea and vomiting, and may recur after eating fatty food. Unlike gastritis or indigestion, it characteristically begins suddenly. If the pain continues for more than 5–6 hours or is accompanied by fever, complications such as acute cholecystitis are possible and the patient should go to a hospital promptly.
Abdominal ultrasound is mainly used for diagnosis and can identify more than 90% of gallstones. Computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) is performed additionally if necessary. If there are no symptoms and the risk of complications is low, the condition is monitored, but preventive surgery may be considered when there is pain, when the stones are 3cm or larger, or when gallbladder calcification or gallbladder polyps are also present.
The standard operation is laparoscopic cholecystectomy. The incision is small, so recovery is quick and, depending on the patient's condition, discharge is possible 1–2 days after surgery. Depending on the state and location of the stones, however, the liver and pancreas may also need to be examined and further treatment may be required, so anyone with suspected gallstone disease is advised to see a hepatobiliary-pancreatic specialist.
Drug therapy is given to some patients. Under limited conditions — pure cholesterol stones smaller than 1.5cm with preserved gallbladder function — treatment with UDCA (ursodeoxycholic acid) may be considered to reduce cholesterol in the bile and dissolve the stones. Because the recurrence rate can reach 50% once the medication is stopped, however, the treatment plan should be drawn up in consultation with a specialist.
To prevent gallstones, it is important to exercise regularly and maintain healthy eating habits. In particular, avoid long spells of fasting and extreme dietary restriction for summer dieting, and lose weight slowly over time. People with a family history of gallstone disease, those who are obese and middle-aged and older adults need to pay even closer attention to managing their lifestyle.
Director Park said, “Gallstone disease requires continued follow-up care, since about 1–2% of even asymptomatic patients develop symptoms each year.” He added, “Avoid lifestyle habits that raise the risk, and if sudden abdominal pain or digestive symptoms keep recurring, we recommend getting an accurate diagnosis from a specialist.”
Source: Asia Today (https://www.asiatoday.co.kr)
According to Health Insurance Review and Assessment Service data released on the 14th, gallstone disease largely affects people aged 60 and over, but in summer the increase in patients in their 20s to 50s stands out. Over the past three years, the average 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 — 1.5 and 1.7 times the 5.6% increase among people in their 60s.
Experts point to summer lifestyle habits as one of the causes. Park Kwan-tae, general surgery specialist and Director of the Hepatobiliary-Pancreatic & Vascular Center at St. Peter's Hospital, explained, “Gallstone disease is influenced by a range of factors, including obesity, eating habits and rapid weight loss.” He added, “In summer in particular, short-term dieting, irregular meals and extreme dietary restriction all increase, so the risk of gallstone disease rises among younger people.”
Abrupt fasting and very-low-fat, very-low-calorie diets in particular weaken the gallbladder's ability to contract, creating conditions in which bile easily stagnates. Caution is also needed when a large amount of weight is lost in a short period using the GLP-1 obesity drugs now spreading rapidly. In addition, because estrogen, the female hormone, raises cholesterol levels in the bile, women need to be especially careful.
If a gallstone blocks the cystic duct or the bile duct, sudden severe pain can appear in the upper abdomen or the right upper abdomen. The pain lasts from as little as 30 minutes to as long as several hours, may be accompanied by nausea and vomiting, and may recur after eating fatty food. Unlike gastritis or indigestion, it characteristically begins suddenly. If the pain continues for more than 5–6 hours or is accompanied by fever, complications such as acute cholecystitis are possible and the patient should go to a hospital promptly.
Abdominal ultrasound is mainly used for diagnosis and can identify more than 90% of gallstones. Computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) is performed additionally if necessary. If there are no symptoms and the risk of complications is low, the condition is monitored, but preventive surgery may be considered when there is pain, when the stones are 3cm or larger, or when gallbladder calcification or gallbladder polyps are also present.
The standard operation is laparoscopic cholecystectomy. The incision is small, so recovery is quick and, depending on the patient's condition, discharge is possible 1–2 days after surgery. Depending on the state and location of the stones, however, the liver and pancreas may also need to be examined and further treatment may be required, so anyone with suspected gallstone disease is advised to see a hepatobiliary-pancreatic specialist.
Drug therapy is given to some patients. Under limited conditions — pure cholesterol stones smaller than 1.5cm with preserved gallbladder function — treatment with UDCA (ursodeoxycholic acid) may be considered to reduce cholesterol in the bile and dissolve the stones. Because the recurrence rate can reach 50% once the medication is stopped, however, the treatment plan should be drawn up in consultation with a specialist.
To prevent gallstones, it is important to exercise regularly and maintain healthy eating habits. In particular, avoid long spells of fasting and extreme dietary restriction for summer dieting, and lose weight slowly over time. People with a family history of gallstone disease, those who are obese and middle-aged and older adults need to pay even closer attention to managing their lifestyle.
Director Park said, “Gallstone disease requires continued follow-up care, since about 1–2% of even asymptomatic patients develop symptoms each year.” He added, “Avoid lifestyle habits that raise the risk, and if sudden abdominal pain or digestive symptoms keep recurring, we recommend getting an accurate diagnosis from a specialist.”
Source: Asia Today (https://www.asiatoday.co.kr)