Gallstones Raise the Risk of Heart Disease by a Fifth

A new meta-analysis, using data from hundreds of thousands of individuals, finds that gallbladder disease and heart disease are more intertwined than previously thought. The reasons behind this connection are, as yet, unclear.

Gallstones are small, hard deposits that form in the gallbladder - an organ that sits below the liver.

In wealthier countries, they are a common occurrence, affecting 10-15 percent of all adults.

Gallstones are thought to be produced due to an imbalance in the makeup of bile - a digestive aid produced by the liver and concentrated in the gallbladder.

Although generally small and often symptomless, over the years, gallstones can grow to the size of pebbles.

Read more: Gallstones Raise the Risk of Heart Disease by a Fifth

Gallstones' links to heart disease run deeper than previously thought.

Source: medicalnewstoday

Gallbladder Problems: Signs, Symptoms, Treatments and Outlooks

Most people don't pay much attention to their gallbladder until it starts causing trouble. However, when the gallbladder starts acting up, it can be quite painful and require immediate action.

This article will look at what the gallbladder does, the symptoms of a problem with the gallbladder, treatment options, and long-term outlook.

What is the gallbladder?

The gallbladder is a 4-inch-long pear-shaped organ found under the liver in the upper right quadrant of the abdomen. It stores the bile the liver makes to digest fat.

Read more: Gallbladder Problems: Signs, Symptoms, Treatments and Outlooks

The gallbladder is found just below the liver. Its job is to store bile used to digest fat.

Source: medicalnewstoday

Gallstones: Epidemiology, Pathophysiology and Management.

Gallstones grow inside the gallbladder or biliary tract. These stones can be asymptomatic or symptomatic; only gallstones with symptoms or complications are defined as gallstone disease. Based on their composition, gallstones are classified into cholesterol gallstones, which represent the predominant entity, and bilirubin (‘pigment’) stones. Black pigment stones can be caused by chronic hemolysis; brown pigment stones typically develop in obstructed and infected bile ducts. For treatment, localization of the gallstones in the biliary tract is more relevant than composition. Overall, up to 20% of adults develop gallstones and >20% of those develop symptoms or complications. Risk factors for gallstones are female sex, age, pregnancy, physical inactivity, obesity and over nutrition. Factors involved in metabolic syndrome increase the risk of developing gallstones and form the basis of primary prevention by lifestyle changes. Common mutations in the hepatic cholesterol transporter ABCG8 confer most of the genetic risk of developing gallstones, which accounts for ∼25% of the total risk. Diagnosis is mainly based on clinical symptoms, abdominal ultrasonography and liver biochemistry tests. Symptoms often precede the onset of the three common and potentially life-threatening complications of gallstones (acute cholecystitis, acute cholangitis and biliary pancreatitis). Although our knowledge on the genetics and pathophysiology of gallstones has expanded recently, current treatment algorithms remain predominantly invasive and are based on surgery. Hence, our future efforts should focus on novel preventive strategies to overcome the onset of gallstones in at-risk patients in particular, but also in the population in general.

Introduction

Gallstones (cholelithiasis) are masses in the gallbladder or biliary tract that are caused by abnormally high levels of either cholesterol or bilirubin (a breakdown product of heme) in bile (Fig. 1). Gallstones are common (∼10–20% of the global adult population), and >20% of people with gallstones will develop symptoms in their lifetime (including biliary colic or infections), usually in adulthood. Gallstone disease is defined by the occurrence of symptoms or complications caused by gallstones in the gallbladder and/or the bile ducts. From a clinical perspective and in treatment algorithms, those with asymptomatic stones are not generally classified as having gallstone disease. Gallstone disease is among the gastrointestinal conditions associated with the highest socioeconomic costs.

Read more: Gallstones: Epidemiology, Pathophysiology and Management.

Figure 1: Classification of gallstones.

PrimeView Poster:

Gallstones are masses in the gallbladder or biliary tract. 10–20% of adults will develop gallstones in their lifetime, and >20% of those will develop symptoms or complications. This Primer by Lammert et al. focuses on the formation of gallstones, summarizes the current principles of treatment of the stones and their potential complications and envisions future approaches for this widespread disease. And this PrimeView focuses on the most common risk factors, which include genetics, ethnicity, sex, age, drugs, parasites, over nutrition and pregnancy.

Frank Lammert, Kurinchi Gurusamy, Cynthia W. Ko,Juan-Francisco Miquel, Nahum Méndez-Sánchez, Piero Portincasa, Karel J. van Erpecum, Cees J. van Laarhoven& David Q.-H. Wang

View poster: Gallstone Poster (high-resolution PDF (1.30 MB))

Source: NatureReviewsDiseasePrimers