Hong Kong’s famous entertainer Shen Tianxia, nicknamed “Fatty” by her audience, who brought endless laughter to people, died recently in Hong Kong’s Queen Mary Hospital after a long illness. It is said that “Fatty” suffered from gallstones six years ago, followed by recurrent inflammation of the bile ducts, and was eventually diagnosed with bile duct cancer. He died of liver failure. The death of “Fatty” has aroused everyone’s concern about gallstone disease. In this regard, medical experts believe that the “F4” people should pay particular attention to “bile”, regular body checks to prevent gallstone disease and other chronic diseases on the body. 1, why the “F4” a family vulnerable to gallstone disease The so-called “F4” refers to four words beginning with the letter F, namely female (Female), obese (Fat), 40 years old (Forty), multiple births (Fertile). (1) Female: According to statistics, the incidence of gallbladder disease, especially gallstones, is three to four times higher in women than in men. Compared with men, women are reluctant to be active, have less physical work and often have sedentary habits. This makes the gallbladder contraction force decrease, the sphincter at the opening of the bile duct dysfunction, delayed emptying of the gallbladder, bile stagnation, conducive to bacterial reproduction, stone formation. In addition, due to the effect of estrogen in women, middle-aged and elderly women are more likely to gain weight than men, and the cholesterol content in blood and bile increases. (2) Obesity (Fat): Some studies have shown that the incidence of gallstones is 5 times higher than normal in people whose body weight exceeds the normal standard by more than 15%. Because fat people are often accompanied by high cholesterol, cholesterol gathers more in the bile, forming cholesterol crystals, and then gallstones easily appear; at the same time, middle-aged fat women exercise less, which easily leads to a decrease in the contraction force of the gallbladder muscle, delayed bile emptying, resulting in bile depression. (3) 40 years old (Forty): After entering middle age, people’s physical activity decreases, and fat metabolism synthesis is greater than decomposition, the body begins to “fat”, when the gallbladder function is weakened, the bile duct peristalsis slows down, bile stagnation, easy to induce cholecystitis and cholelithiasis. In addition, female estrogen makes cholesterol gather more in the bile, and women over 40 years old are prone to stone formation because of the decrease of estrogen and metabolic level in their bodies. (4) Multiple childbirth (Fertile): Pregnancy is a trigger for the formation of gallstones and cholecystitis. Under normal circumstances, after childbirth and breastfeeding, fat metabolism returns to its original level. However, multiple childbirths can disrupt cholesterol metabolism, creating opportunities for gallbladder infection and gallstones to form. In fact, cholecystitis and gallstones tend to occur in late pregnancy and during the menstrual period. Because the enlarged uterus in late pregnancy compresses the opening of the common bile duct in the duodenum, so that bile can not be smoothly discharged to the intestine, coupled with the sudden reduction of activities during menstruation, bile stagnation in the gallbladder, which is conducive to bacterial reproduction, but also because of the concentration of bile, cholesterol saturation and deposition, providing favorable conditions for the formation of stones and inflammation. 2, what is the harm of gallstone disease Gallstone disease not only brings inconvenience to people’s life and work, but also can even be life-threatening in serious cases. The common hazards of gallstone disease are: (1) cholecystitis: there are two types of cholecystitis: acute cholecystitis and chronic cholecystitis, bacterial infection usually causes acute cholecystitis, if the acute cholecystitis often recurrence will cause chronic cholecystitis, but sometimes chronic cholecystitis also acute attacks. Gallstones are stones that appear in the gallbladder or bile ducts. They are usually the main cause of cholecystitis, and at the same time, when you have cholecystitis, gallbladder exudate forms gallstones again, turning into a cycle that repeats itself. (2) Gallbladder necrosis and perforation, biliary peritonitis: once the gallbladder is necrotic and perforated, purulent bile flows into the abdominal cavity, causing peritonitis. This is a more serious complication, and elderly patients are especially prone to it. The manifestations are: sudden increase in abdominal pain, abdominal muscle pressure pain, abdominal tension rebound pain. (3) Biliary pancreatitis: bile stones embedded in the abdomen of the common bile duct or damage to the duodenal papilla during expulsion may cause bile to flow back into the pancreatic duct, thus inducing acute pancreatitis. (4) Bacterial liver abscess: After the stone obstructs the bile duct and forms purulent cholangitis, the bacteria spread upward from the bile duct to the liver, causing liver abscess, which manifests as: right upper abdominal distension and pain, chills and high fever, profuse sweating and general weakness. (5) Biliary tract bleeding: Bile duct inflammation forms abscess, which breaks down and erodes the blood vessels in the liver and occurs. The manifestations are: severe colic in the right upper abdomen, vomiting of blood (or resolution of black stool), and shock in severe cases. (6) Acute obstructive purulent cholangitis: It is one of the common complications of gallstones, which manifests as the triad of fever, abdominal pain, jaundice, and shock in severe cases. (7) Toxic shock: the bile duct is obstructed by stones and infections occur, caused by absorption of bacterial toxins. Its manifestations are: right upper abdominal pain, jaundice, high fever, chills, dizziness, irritability, pallor, cold extremities, and decreased blood pressure. 3.How to prevent and treat cholelithiasis The symptoms of cholelithiasis are pain in the right upper abdomen after eating greasy food and radiating pain in the back of the right shoulder. These symptoms are non-specific and similar to those of gastrointestinal and liver diseases, so patients often mistake gastrointestinal diseases or liver diseases for non-cholestasis examination at the beginning, and delay the diagnosis. Therefore, when symptoms such as pain in the right upper abdomen occur, it is also important to consider whether it is caused by gallstones and to do the relevant tests early in order to confirm the diagnosis and treat it as soon as possible. Once you have gallstone disease, most of the current methods of lithotripsy and stone removal cannot solve the problem completely, and the recurrence rate is also high, so the better treatment method is gallbladder removal. There are two types of gallbladder removal: open surgery and laparoscopic surgery, and laparoscopic surgery is currently the first choice. The cure rate of gallstones is also higher due to early detection and timely diagnosis and treatment. Therefore, regular checking of blood lipids, cholesterol and through ultrasound can help to detect stones at an early stage. 4.Does gallstone disease require painful removal of gallbladder There are many misconceptions about gallstone disease, such as gallbladder disease will not be fatal if you simmer; gallbladder stones are not painful, you do not need to remove the gallbladder; long polyps must remove the gallbladder and so on. In fact, less than 10% of gallstone patients are able to “live peacefully” with stones. For the rest of patients, especially if the stones are sediment-like or more than 2 cm in diameter, they can easily cause acute pancreatitis and even gallbladder or bile duct cancer. Even if the stones are too small for patients to feel pain, these “dots” are easy to move and once they are blocked in the neck of the gallbladder or the bile duct, they can cause severe upper abdominal pain, nausea, vomiting, acute cholecystitis, acute obstructive purulent cholangitis, etc. It is also wrong to think that “polyps must be removed from the gallbladder”. In fact, about 50% of patients with gallbladder polyps can be spared a cut by undergoing regular monitoring. Only those patients with polyps over 1 cm in diameter and combined with stones or gallbladder inflammation, which does not exclude malignant change, must have their gallbladder removed. 5.How to prevent gallstone disease (1) The best way to prevent gallstone disease is to eat regularly. After eating, bile acids are discharged from the liver and gallbladder, enter the intestine to help digestion, and then enter the liver and gallbladder through the intestine. If you often skip meals in the morning, the circulation mechanism will be disrupted and the flow of bile acids will be reduced, which will not be able to dissolve cholesterol sufficiently, thus leading to an increase in the concentration of cholesterol and its precipitation, and stones will be formed. (2) Attention should be paid to dietary regulation, meals should be varied, and as little greasy food as possible, and those whose diet is meat and sweet are also prone to the formation of gallstones due to high fat and cholesterol intake. Too much sweet food will promote the secretion of insulin, which will accelerate the deposition of cholesterol in the bile and form gallstones. (3) Limit cholesterol intake, should not eat animal offal, seafood, less fried food and pastry, less stimulating spices, carbonated drinks, alcohol and other foods that promote gastric juice secretion, gastric juice will stimulate the contraction of the gallbladder, increasing the occurrence of stones. (4) Raw and cold, high-protein, stimulating foods and strong alcohol are easy to help dampness and generate heat, making bile stagnation, and should also be eaten sparingly. Vegetables and fruits rich in vitamin A and vitamin C, fish and seafood can help to clear the bile and dissolve stones. (5) life should be regular, pay attention to the combination of work and rest, strengthen sports and exercise, especially the office family after a sedentary exercise in time, running and jumping, can enhance the gallbladder diastolic function. In addition, obesity and hyperlipidemia patients, the appropriate application of lipid-lowering drugs, can also reduce the chance of gallstone disease.