The incidence of gallbladder stones is very high in some areas of China, and in some areas it is even reported to be about 15% of the normal population, and it is the disease that receives the largest number of surgical treatments in China. Patients undergoing cholecystectomy in our hepatobiliary department account for about 40% of the total number of operations, and patients undergoing cholecystectomy in primary care hospitals account for more than half of all general surgical operations, far exceeding the number of patients undergoing appendectomy, hernia repair, etc., which shows the danger of this disease.
Gallbladder stones are considered a lifestyle disease, and “eating” and “exercise” play an important role in the development of gallbladder stones, in addition, environmental and genetic factors also have an important impact on the development of gallbladder stones. Here, we will take a look at those factors that have an important impact on the formation of gallbladder stones.
1.Type of diet
The formation of gallbladder stones is directly related to the total calories eaten. A high-calorie, low-fiber diet increases the saturation of cholesterol in the bile, which easily precipitates into cholesterol crystals, which can be called the core of stone formation. Gallstones in China used to be dominated by bile pigment stones, but as the standard of living improves, cholesterol stones are becoming more and more common. Therefore, excessive calorie intake, whether from rice and flour or meat, eggs and milk, can easily lead to stone formation. It is especially important to note that gallbladder stones also occur in student groups who often consume high-calorie Western food such as burgers and fries, even in children under 10 years old.
2.Eating habits
Irregular eating habits, especially the habit of not eating breakfast is an important trigger for gallbladder stones. When fasting in the morning, the bile in the gallbladder is stored overnight and the cholesterol saturation is high. In the case of normal breakfast, the gallbladder contracts so that the cholesterol is discharged with the bile, while secreting new bile, which will reduce the saturation of cholesterol in the gallbladder, making it less likely to form stones; if you do not eat breakfast, the gallbladder will not contract, and the bile is stored for too long, resulting in the cholesterol in a supersaturated state, which will easily cause cholesterol deposits and gradually form stones. Therefore, it is of positive significance to maintain a good and regular diet to promote the regular discharge of bile from the gallbladder into the intestine to prevent stone formation and maintain the good function of the gallbladder.
3. Obesity
The incidence of gallbladder stones is significantly higher in obese people than in normal-sized people, especially in obese women over 40 years old, and women at that age love to eat high-fat, high-sugar, high-cholesterol drinks or snacks and female estrogen will make cholesterol gather more in the bile. In addition, obesity after the incidence of fatty liver increased, objectively also increased the occurrence of gallbladder stones.
4, sedentary habits
Now many families in China can see such a situation, the family after dinner, leisurely sitting on the sofa, while eating snacks, chatting and watching TV. This habit of sitting and snacking after meals may be one of the reasons for the high incidence of gallstones in China. Bile secretion increases after eating, while sitting or lying down after the increase in abdominal pressure, gastrointestinal peristalsis slows down, which is not conducive to the digestion and absorption of food and bile excretion, but also hinders the reabsorption of bile acids, resulting in the imbalance of the ratio of cholesterol to bile acids in bile, cholesterol is easy to deposit.
5.Long-term less exercise
Many women, especially middle-aged women, tend to spend more time at home and less time exercising and doing physical work, which inevitably decreases the contraction force of their gallbladder muscle over time and delays the emptying of bile, easily causing bile stasis and cholesterol crystals to precipitate, creating conditions for the formation of gallstones. In addition, the high level of estrogen in women affects the formation of glucuronide bilirubin in the liver, which increases non-conjugated bilirubin, and estrogen affects the emptying of the gallbladder, causing stagnation of bile and sweat and promoting stone formation. The incidence of gallstones increases significantly in postmenopausal estrogen users.
6.Biliary tract infection
Biliary infection is the most common cause of gallbladder stone formation, gallbladder inflammation and gallbladder stones often exist at the same time and affect each other, it can also be said that gallbladder inflammation creates the conditions for stone formation, where the infectious inflammatory lesions of the gallbladder, without treatment, or certainly after treatment, but after a long time, sooner or later there will be the possibility of stone formation. It has been reported in the literature that B. typhimurium, Streptococcus, Bacillus Weiss, and Actinomyces have been cultured from the gallstone core, which shows that bacterial infection has an important role in stone formation. In addition to causing gallbladder inflammation, bacterial infection, its colonies and shed epithelial cells can become the core of stones, and the protein component of inflammatory exudate in the gallbladder can become the scaffold of stones. In our country, gallbladder stones are almost always accompanied by cholecystitis, and generally symptomatic patients with gallbladder stones are accompanied by inflammation. Most chronic inflammation is difficult to be cured by conservative methods, and most of these patients need to receive surgical treatment.
7.Heredity
Genetic factors clearly play an important role in defining the risk of gallstones. Gallstones are more frequently produced in close relatives of patients with cholesterol gallstone disease. The fact that local Americans in the southwestern United States have a high risk of developing cholesterol gallstone disease (>80%) appears to contain a genetic factor.
8. Influence of systemic diseases
Certain systemic diseases, due to changes in the internal environment, are more likely to occur gallbladder stones, and it is now clinically clear that the incidence of gallbladder stones is significantly higher in patients with cirrhosis of the liver, diabetes, after major abdominal surgery, and long-term bed rest than in the normal population.
9.Female pregnancy
During pregnancy, the biliary tract function of women is easily disturbed, resulting in weak contraction of smooth muscles and retention of bile in the gallbladder, and the relative increase of cholesterol in the blood during pregnancy, which is prone to precipitation.