Gallbladder Disease, Obesity, & Weight Loss Surgery

Gallbladder disease is one of the most common surgical conditions seen in our society. The surgical procedure to treat gallbladder disease is known as a cholecystectomy, which is the removal of the gallbladder. Gallbladder disease is indicated by the presence of gallstones, which can be detected with an ultrasound. The most common symptom of gallstones is periodic pain that occurs when gallstones block the outlet of the gallbladder. This recurring pain represents the classic “gallbladder attack.” The pain is felt just under the breastbone in an area called the epigastrum, commonly referred to as the “pit” of the stomach. The pain will also often move to the back, and can be accompanied by nausea and occasional vomiting. “Gallbladder attacks” usually last no more than a few hours before the pain spontaneously resolves. If the pain only slightly subsides for a moment before increasing and settling to just below the right rib cage, an infection in the gallbladder could be developing. This complication of gallbladder disease is known as cholecystitis.

One of the major causes among the many risk factors for gallbladder disease is obesity. When you’re over of your ideal body weight, the incidence of gallstones starts going up. People who are overweight or obese have more cholesterol in their bile, and gallstones are basically deposits of cholesterol. The more cholesterol you have in your bile, the more likely it is to form gallstones.

The distribution of fat in the body also contributes to the development of gallstones. A recent study found that men with more fat around their abdomens had a greater chance of developing problematic gallstones than those with smaller waistlines and for women with BMI’s greater than 32 may be as much as three times as likely to develop gallstones as those with a BMI of 24 or 25. The risk may be seven times higher in women with a BMI above 45 than in those with a BMI under 25.

Individuals that still have their gallbladder prior to surgery may develop symptomatic gallstones after rapid weight loss. Studies suggest that a patient undergoing weight-loss surgery can have as high as a 25-30 percent risk of developing symptomatic gallstones within the first year after any bariatric procedure and it’s shown 30 percent of bariatric patients will need their gallbladders surgically removed during the rapid weight-loss phase. Due to the rapidness of the weight that occurs with bariatric surgery it somehow changes the composition, in some ill-defined way, of the protein within the bile, and makes it more likely that cholesterol would precipitate out. Once the weight loss stops, the risk of gallstones decreases. Although losing weight at more rapid rate may increase the risk of developing gallstones, obesity poses an even greater risk. If you start to experience any of the symptoms above you may be experiencing a gallbladder attack and you should contact your Doctor or Surgeon.

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