What is the Treatment for Gallstones?
Silent gallstones are usually left alone and occasionally disappear on their own. Usually only patients with symptomatic gallstones are treated.The most common treatment for gallstones is surgery to remove the gallbladder. This operation is called a cholecystectomy. In rare cases, drugs are used to dissolve the gallstones. Other nonsurgical methods are still considered experimental.
The drug ursodeoxycholic acid prevented gallstones from forming in one clinical trial of patients on very-low-calorie diets. However, the drug is costly. Given the small proportion of patients who develop symptomatic gallstones on very-low-calorie diets, it is not known if ursodeoxycholic acid would be a cost-effective drug to recommend for all patients undergoing such diets, though people with preexisting gallstones may benefit from this drug.
Are the Benefits of Weight Loss Greater Than the Risk of Getting Gallstones?
There's no question that obesity poses serious health risks. Obesity has been linked to heart disease, stroke, high blood pressure, high cholesterol levels, and diabetes. Obesity has also been associated with higher rates of certain types of cancer, such as gallbladder, colon, prostate, breast, cervical, and ovarian cancers.Weight loss also reduces the risk of heart disease by lowering cholesterol levels. Even a modest weight loss of 10 to 20 pounds can bring positive changes. And the psychological boost from losing weight, such as improved self-image and greater social interaction, should not be ignored.
Patients who are thinking about beginning a commercial diet program to lose a significant amount of weight should talk with their doctors. A physician can evaluate a patient's medical history, individual circumstances, and the proposed weight-loss program. Doctor and patient can then discuss the potential benefits and risks of dieting, including the risks of developing gallstones.
Additional Reading
Clayman CB, ed. The American Medical Association Encyclopedia of Medicine. New York: Random House. 1989. This authoritative reference guide for patients has entries on the gallbladder, gallstones, and the biliary system. It is widely available in libraries and bookstores.
Everhart, J.E. Contributions of Obesity and Weight-Loss to Gallstone Disease. Annals of Internal Medicine 1993, Vol. 119, pp 1029-35. This article, written for physicians, shows how obesity as well as weight loss and low calorie diets increase the risk of gallstones.
Gallstones. NIH Publication No. 93-2897. This fact sheet provides basic information about gallstones and treatment options. It is published by the National Institute of Diabetes and Digestive and Kidney Diseases and is available through the National Digestive Diseases Information Clearinghouse, Box NDDIC, 9000 Rockville Pike, Bethesda, MD 20892, Tel: 301-654-3810.
Weinsier RL, et. al. Gallstone Formation and Weight Loss. Obesity Research, 1993; 1 (1): pp 51-56. This review article, written for physicians, examines gallstone formation rates in patients on very-low-calorie diets, including the role that fasting and diet composition may play.
Yang H., et. al. Risk Factors for Gallstone Formation during Rapid Loss of Weight. Digestive Diseases and Sciences. Vol. 37, No. 6 (June 1992), pp 912-18. This article, written for physicians, discusses gallstone formation in patients on very-low-calorie diets.
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