'Young gallstones' brought on by extreme dieting…how do they differ from indigestion?
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St. Peter's Hospital 26-08-17 08:53Main content
Gallstone disease, known to be common in older adults, is occurring in younger people to no small degree. Crash dieting — such as drastically cutting food intake to lose weight in a short period — is being cited as the cause.
In fact, according to the Health Insurance Review and Assessment Service, gallstone patients in their 20s and 30s rose about 4.1%, from 32,516 in 2021 to 33,852 in 2025. In 2025 there were 18,841 female patients in their 20s and 30s, about 1.3 times more than male patients (15,011).
■Said to be a disease of older adults…but young people aren't safe either
Gallstone disease is a condition in which sediment in the bile hardens into stones in the gallbladder or bile ducts. The gallbladder stores bile produced by the liver and releases it at mealtimes to aid the digestion of fats. If the balance of the bile's components breaks down, or the bile is not released properly, gallstones can form.
Park Kwan-tae, 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.”
■Why starvation dieting creates gallstones
The problem lies less in dieting itself than in rapid weight loss over a short period, long spells without food, and extreme food restriction.
Going without food for a long time means the gallbladder goes longer without releasing bile, making it easy for the bile to stagnate. Extreme fasting and very-low-fat, very-low-calorie diets likewise reduce gallbladder contraction and can create conditions in which gallstones form easily.
Women need to be especially careful, because estrogen, the female hormone, acts to raise cholesterol levels in the bile.
Yang Geun-hyeok, Professor of Gastrointestinal Surgery at Kyung Hee University Hospital at Gangdong, said, “Estrogen, the female hormone, acts to raise cholesterol levels in the bile, so women are fundamentally at greater risk than men.” He added, “When dieting that involves long spells of fasting is added on top, it causes bile stagnation and drives the risk of stone formation higher still.”
■Confused with indigestion or gastritis…'sudden pain' is the clue
Gallstone disease often causes no symptoms at all. Even when symptoms do appear, they resemble ordinary indigestion, such as bloating after meals, so it is easy to take a digestive aid and think no more of it. But if these symptoms recur after overeating or eating fatty food, gallstone disease should also be suspected.
A more characteristic symptom is 'biliary colic'. Unlike gastritis or indigestion, in which heartburn and similar symptoms persist, severe pain appears suddenly in the pit of the stomach or the right upper abdomen and can last from 30 minutes to several hours. It may be accompanied by nausea and vomiting, or radiate to the right shoulder blade or the back.
Director Park Kwan-tae urged, “In particular, if the pain lasts more than 5–6 hours or is accompanied by fever or body aches, there is a risk of complications such as acute cholecystitis, so a hospital should be visited quickly.”
■Do gallstones always mean surgery?…what matters is whether there are symptoms
Gallstone disease can be confirmed by abdominal ultrasound. The presence, location and size of the stones and the state of the gallbladder are examined, and CT or magnetic resonance cholangiopancreatography (MRCP) is performed additionally if necessary.
Finding gallstones does not automatically mean surgery. If there are no particular symptoms, the size and number of the stones and changes in the gallbladder wall can be monitored regularly. If the stones cause pain, however, cholecystectomy may be performed in light of the risk of complications.
Professor Yang Geun-hyeok explained, “Even if the gallbladder is left in place and only the stones are removed, the organ is already diseased and its function reduced, so there is a very high chance that stones will form again over time.” He added, “Rather than undergoing repeated operations for recurrence, removing the gallbladder itself, the cause, is the safer and more fundamental treatment.”
■Digestion stays normal even after the gallbladder is removed
Even after the gallbladder is removed, bile — the digestive fluid — continues to be produced normally by the liver, so digestion is not permanently impaired.
Professor Yang added, “After surgery, however, bile flows straight into the intestine without being stored, so for about a month there may be temporary indigestion or frequent bowel movements after meals.” He advised, “During this period it is best to keep to a low-fat diet that avoids greasy food and to chew food slowly.”
With the help of digestive aids or choleretic medication when needed, the bile ducts take over some of the function over time, and patients can return to normal life without major problems as long as they avoid excessive eating habits such as overeating.
To prevent gallstone disease, it is important to eat regularly and lose weight gradually rather than simply going without food. Avoid long spells of fasting and extreme dietary restriction, and combine this with regular exercise.
Source: Health Kyunghyang (https://www.k-health.com)
In fact, according to the Health Insurance Review and Assessment Service, gallstone patients in their 20s and 30s rose about 4.1%, from 32,516 in 2021 to 33,852 in 2025. In 2025 there were 18,841 female patients in their 20s and 30s, about 1.3 times more than male patients (15,011).
■Said to be a disease of older adults…but young people aren't safe either
Gallstone disease is a condition in which sediment in the bile hardens into stones in the gallbladder or bile ducts. The gallbladder stores bile produced by the liver and releases it at mealtimes to aid the digestion of fats. If the balance of the bile's components breaks down, or the bile is not released properly, gallstones can form.
Park Kwan-tae, 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.”
■Why starvation dieting creates gallstones
The problem lies less in dieting itself than in rapid weight loss over a short period, long spells without food, and extreme food restriction.
Going without food for a long time means the gallbladder goes longer without releasing bile, making it easy for the bile to stagnate. Extreme fasting and very-low-fat, very-low-calorie diets likewise reduce gallbladder contraction and can create conditions in which gallstones form easily.
Women need to be especially careful, because estrogen, the female hormone, acts to raise cholesterol levels in the bile.
Yang Geun-hyeok, Professor of Gastrointestinal Surgery at Kyung Hee University Hospital at Gangdong, said, “Estrogen, the female hormone, acts to raise cholesterol levels in the bile, so women are fundamentally at greater risk than men.” He added, “When dieting that involves long spells of fasting is added on top, it causes bile stagnation and drives the risk of stone formation higher still.”
■Confused with indigestion or gastritis…'sudden pain' is the clue
Gallstone disease often causes no symptoms at all. Even when symptoms do appear, they resemble ordinary indigestion, such as bloating after meals, so it is easy to take a digestive aid and think no more of it. But if these symptoms recur after overeating or eating fatty food, gallstone disease should also be suspected.
A more characteristic symptom is 'biliary colic'. Unlike gastritis or indigestion, in which heartburn and similar symptoms persist, severe pain appears suddenly in the pit of the stomach or the right upper abdomen and can last from 30 minutes to several hours. It may be accompanied by nausea and vomiting, or radiate to the right shoulder blade or the back.
Director Park Kwan-tae urged, “In particular, if the pain lasts more than 5–6 hours or is accompanied by fever or body aches, there is a risk of complications such as acute cholecystitis, so a hospital should be visited quickly.”
■Do gallstones always mean surgery?…what matters is whether there are symptoms
Gallstone disease can be confirmed by abdominal ultrasound. The presence, location and size of the stones and the state of the gallbladder are examined, and CT or magnetic resonance cholangiopancreatography (MRCP) is performed additionally if necessary.
Finding gallstones does not automatically mean surgery. If there are no particular symptoms, the size and number of the stones and changes in the gallbladder wall can be monitored regularly. If the stones cause pain, however, cholecystectomy may be performed in light of the risk of complications.
Professor Yang Geun-hyeok explained, “Even if the gallbladder is left in place and only the stones are removed, the organ is already diseased and its function reduced, so there is a very high chance that stones will form again over time.” He added, “Rather than undergoing repeated operations for recurrence, removing the gallbladder itself, the cause, is the safer and more fundamental treatment.”
■Digestion stays normal even after the gallbladder is removed
Even after the gallbladder is removed, bile — the digestive fluid — continues to be produced normally by the liver, so digestion is not permanently impaired.
Professor Yang added, “After surgery, however, bile flows straight into the intestine without being stored, so for about a month there may be temporary indigestion or frequent bowel movements after meals.” He advised, “During this period it is best to keep to a low-fat diet that avoids greasy food and to chew food slowly.”
With the help of digestive aids or choleretic medication when needed, the bile ducts take over some of the function over time, and patients can return to normal life without major problems as long as they avoid excessive eating habits such as overeating.
To prevent gallstone disease, it is important to eat regularly and lose weight gradually rather than simply going without food. Avoid long spells of fasting and extreme dietary restriction, and combine this with regular exercise.
Source: Health Kyunghyang (https://www.k-health.com)