How does weight loss affect gallstone formation. What are the risks of developing gallstones during rapid weight loss. How can gallstone formation be prevented during weight loss.

The Link Between Obesity and Gallstone Formation

Obesity has been strongly associated with an increased risk of gallstone development. This connection stems from several factors:

• Increased bile stasis (slowing of bile flow)
• Higher cholesterol saturation in bile
• Greater overall risk of gallstone formation

Interestingly, when individuals with obesity lose weight, their bile composition tends to normalize. This would suggest that weight loss could potentially reduce the predisposition to gallstone formation. However, the relationship between weight loss and gallstones is more complex than it initially appears.

The Paradox of Very-Low-Calorie Diets and Gallstone Risk

Despite the potential health benefits of weight reduction, very-low-calorie diets (VLCDs) have been found to paradoxically increase the risk of gallstone formation. This increased risk appears to be influenced by several factors:

• The degree of caloric restriction
• The rate of weight loss
• The duration of the dietary intervention

Research indicates that faster rates of weight loss maintained over longer periods are associated with a higher risk of gallstone formation. But why does this occur?

Mechanisms Behind Gallstone Formation During Rapid Weight Loss

Several mechanisms have been proposed to explain the increased risk of gallstone formation during rapid weight loss:

1. Bile stasis due to reduced caloric intake
2. Increased biliary cholesterol saturation secondary to increased cholesterol mobilization
3. Enhanced nucleation due to changes in bile arachidonate and glycoprotein concentrations

These factors combine to create an environment in the gallbladder that is more conducive to stone formation.

Incidence and Timeline of Gallstone Formation During Weight Loss

Prospective studies on subjects undergoing active weight loss have provided valuable insights into the incidence and timeline of gallstone formation:

• Newly formed gallstones can appear within 4 weeks of starting a very-low-calorie diet
• The incidence rates are 15 to 25-fold higher than in the general obese population
• Approximately one-third of individuals with newly formed stones experience symptoms
• Of those with symptoms, about half will ultimately require surgery

These statistics highlight the significant impact that rapid weight loss can have on gallstone formation and subsequent health complications.

The Role of Gallbladder Emptying in Gallstone Formation

Gallbladder motility plays a crucial role in preventing gallstone formation. During periods of rapid weight loss, particularly when following very-low-calorie diets, gallbladder emptying can be impaired. This impairment can contribute to the formation of gallstones.

A study by Gebhard et al. (1996) investigated the relationship between gallbladder emptying and gallstone formation during diet-induced rapid weight loss. The researchers found that reduced gallbladder motility was a significant factor in the development of gallstones during weight loss interventions.

The Sequence of Biliary Events Leading to Gallstone Formation

Understanding the sequence of biliary events that precede gallstone formation is crucial for developing preventive strategies. Marks et al. (1992) conducted a study to elucidate this process in humans. Their findings shed light on the complex series of changes that occur in the biliary system before gallstones actually form.

These events typically involve:

1. Changes in bile composition
2. Formation of cholesterol crystals
3. Aggregation of crystals
4. Growth of stones

By understanding this sequence, researchers and clinicians can better target interventions to prevent gallstone formation during weight loss.

Strategies for Preventing Gallstone Formation During Weight Loss

Given the increased risk of gallstone formation during rapid weight loss, it’s important to consider strategies that can help mitigate this risk. Some potential approaches include:

• Gradual weight loss: Aiming for a slower, more sustained rate of weight loss may help reduce the risk of gallstone formation.
• Maintaining adequate fat intake: While it may seem counterintuitive, including some fat in the diet can help stimulate gallbladder contraction and prevent bile stasis.
• Regular physical activity: Exercise may help improve gallbladder motility and reduce the risk of stone formation.
• Adequate hydration: Staying well-hydrated can help prevent bile from becoming too concentrated.
• Consider ursodeoxycholic acid: In some cases, this medication may be prescribed to help prevent gallstone formation during rapid weight loss.

It’s important to note that more research is needed to fully understand the effectiveness of these strategies, particularly in the context of gradual weight loss.

The Importance of Monitoring During Weight Loss

Given the potential risks associated with rapid weight loss and gallstone formation, close monitoring during weight loss interventions is crucial. This may involve:

• Regular check-ups with a healthcare provider
• Ultrasound screenings to detect early stone formation
• Monitoring of symptoms that could indicate gallstone development
• Adjusting the weight loss plan as needed to minimize risk

By implementing careful monitoring strategies, healthcare providers can help individuals achieve their weight loss goals while minimizing the risk of gallstone formation.

The Need for Further Research

While the connection between rapid weight loss and gallstone formation is well-established, there are still many unanswered questions in this field. Some areas that require further investigation include:

• The effects of gradual weight loss on gallstone risk
• Optimal rates of weight loss to minimize gallstone formation
• The long-term outcomes of individuals who develop gallstones during weight loss
• The effectiveness of various preventive strategies

Continued research in these areas will help to refine our understanding of the relationship between weight loss and gallstone formation, ultimately leading to safer and more effective weight loss strategies.

Balancing the Benefits and Risks of Weight Loss

While the risk of gallstone formation during rapid weight loss is significant, it’s important to consider this in the context of the overall health benefits of weight loss for individuals with obesity. Obesity itself is associated with numerous health risks, including:

• Cardiovascular disease
• Type 2 diabetes
• Certain types of cancer
• Osteoarthritis
• Sleep apnea

For many individuals, the potential benefits of weight loss may outweigh the risk of gallstone formation. However, this risk-benefit analysis should be conducted on an individual basis, taking into account factors such as:

• The individual’s current health status
• Their weight loss goals
• Their personal risk factors for gallstone formation
• The proposed rate and method of weight loss

By carefully considering these factors, healthcare providers can help individuals make informed decisions about their weight loss journey and implement strategies to minimize the risk of gallstone formation.

The Role of Dietary Composition in Gallstone Prevention

While caloric restriction is a key component of weight loss, the composition of the diet may also play a role in gallstone prevention. Some dietary factors that may influence gallstone risk include:

• Fiber intake: Some studies suggest that a high-fiber diet may help reduce the risk of gallstone formation.
• Protein content: Adequate protein intake may help maintain gallbladder motility.
• Types of fat: While total fat intake should be moderated, including some healthy fats in the diet may be beneficial for gallbladder health.
• Micronutrient content: Certain vitamins and minerals may play a role in preventing gallstone formation.

Further research is needed to fully elucidate the optimal dietary composition for preventing gallstone formation during weight loss. However, these factors should be considered when designing weight loss interventions.

The Potential of Pharmacological Interventions

In some cases, pharmacological interventions may be considered to help prevent gallstone formation during rapid weight loss. The most commonly used medication for this purpose is ursodeoxycholic acid (UDCA). UDCA works by:

• Reducing cholesterol saturation in bile
• Improving gallbladder emptying
• Decreasing intestinal cholesterol absorption

While UDCA has shown promise in reducing the risk of gallstone formation during rapid weight loss, its use should be carefully considered and monitored by a healthcare provider. It’s important to weigh the potential benefits against any possible side effects or interactions with other medications.

Future Directions in Gallstone Prevention During Weight Loss

As our understanding of the relationship between weight loss and gallstone formation continues to evolve, several promising areas of research are emerging:

• Development of new pharmacological agents to prevent gallstone formation
• Exploration of the role of the gut microbiome in gallstone risk
• Investigation of genetic factors that may predispose individuals to gallstone formation during weight loss
• Refinement of imaging techniques for early detection of gallstone formation
• Development of personalized risk assessment tools to guide weight loss strategies

These areas of research hold the potential to significantly improve our ability to prevent gallstone formation during weight loss, ultimately leading to safer and more effective weight management strategies.

In conclusion, while the relationship between weight loss and gallstone formation is complex, a nuanced understanding of this connection can help guide safer and more effective weight loss strategies. By carefully balancing the benefits of weight loss against the risk of gallstone formation, and implementing appropriate preventive measures, healthcare providers can help individuals achieve their weight loss goals while minimizing potential complications. As research in this field continues to advance, we can look forward to even more refined approaches to weight management that prioritize both effectiveness and safety.

Gallstone formation and weight loss

Review

. 1993 Jan;1(1):51-6.

doi: 10.1002/j.1550-8528.1993.tb00008.x.

R L Weinsier 
¹
, D O Ullmann

Affiliations

Affiliation

• ¹ Dept. of Nutrition Sciences, Univ. of Alabama, Birmingham, AL 35294-3360, USA.

• PMID:

  16350561

• DOI:

  10.1002/j.1550-8528.1993.tb00008.x

Free article

Review

R L Weinsier et al.

Obes Res.

1993 Jan.

Free article

. 1993 Jan;1(1):51-6.

doi: 10.1002/j.1550-8528.1993.tb00008.x.

Authors

R L Weinsier 
¹
, D O Ullmann

Affiliation

• ¹ Dept. of Nutrition Sciences, Univ. of Alabama, Birmingham, AL 35294-3360, USA.

• PMID:

  16350561

• DOI:

  10.1002/j.1550-8528.1993.tb00008.x

Abstract

Obesity is associated with increased bile stasis and cholesterol saturation, and an increased risk of gallstone development. Conversely, bile composition is normalized following reduction in body weight. It would appear advantageous to promote weight loss in obesity, which would reduce the predisposition to gallstone formation. Despite the potential health benefits of weight reduction, very-low-calorie diets appear to increase the risk for cholesterol crystal and gallstone formation. The incidence of gallstone formation seems to be dependent on the degree of caloric restriction, the rate of weight loss, and the duration of the dietary intervention. Thus, faster rates of weight loss for longer periods of time are associated with increased risk. Available data obtained from prospective studies of subjects during active weight loss suggest that newly formed gallstones occur within 4 weeks and with incidence rates 15 to 25-fold higher than in the general obese population. The stones produce symptoms in approximately one-third of the subjects, of whom approximately one-half will undergo surgery. Proposed mechanisms underlying gallstone formation during weight reduction include bile stasis due to reduced caloric intake, increased biliary cholesterol saturation secondary to increased cholesterol mobilization, and increased nucleation due to changes in bile arachidonate and glycoprotein concentrations. Data are lacking on the effects of gradual rates of weight loss and risk of gallstone formation.

Similar articles

• The role of gallbladder emptying in gallstone formation during diet-induced rapid weight loss.

  Gebhard RL, Prigge WF, Ansel HJ, Schlasner L, Ketover SR, Sande D, Holtmeier K, Peterson FJ.

  Gebhard RL, et al.
  Hepatology. 1996 Sep;24(3):544-8. doi: 10.1002/hep.510240313.
  Hepatology. 1996.

  PMID: 8781321

  Clinical Trial.

• Gallbladder motility and gallstone formation in obese patients following very low calorie diets. Use it (fat) to lose it (well).

  Festi D, Colecchia A, Orsini M, Sangermano A, Sottili S, Simoni P, Mazzella G, Villanova N, Bazzoli F, Lapenna D, Petroni ML, Pavesi S, Neri M, Roda E.

  Festi D, et al.
  Int J Obes Relat Metab Disord. 1998 Jun;22(6):592-600. doi: 10.1038/sj.ijo.0800634.
  Int J Obes Relat Metab Disord. 1998.

  PMID: 9665682

• Review: low caloric intake and gall-bladder motor function.

  Festi D, Colecchia A, Larocca A, Villanova N, Mazzella G, Petroni ML, Romano F, Roda E.

  Festi D, et al.
  Aliment Pharmacol Ther. 2000 May;14 Suppl 2:51-3. doi: 10.1046/j.1365-2036.2000.014s2051.x.
  Aliment Pharmacol Ther. 2000.

  PMID: 10903004

  Review.

• The sequence of biliary events preceding the formation of gallstones in humans.

  Marks JW, Bonorris GG, Albers G, Schoenfield LJ.

  Marks JW, et al.
  Gastroenterology. 1992 Aug;103(2):566-70. doi: 10.1016/0016-5085(92)90848-s.
  Gastroenterology. 1992.

  PMID: 1634075

• Primary and secondary prevention of gallstone disease: implications for patient management and research priorities.

  Hofmann AF.

  Hofmann AF.
  Am J Surg. 1993 Apr;165(4):541-8. doi: 10.1016/s0002-9610(05)80958-4.
  Am J Surg. 1993.

  PMID: 8386910

  Review.

See all similar articles

Cited by

• Prevention of Gallstones After Bariatric Surgery using Ursodeoxycholic Acid: A Narrative Review of Literatures.

  Son SY, Song JH, Shin HJ, Hur H, Han SU.

  Son SY, et al.
  J Metab Bariatr Surg. 2022 Dec;11(2):30-38. doi: 10.17476/jmbs.2022.11.2.30. Epub 2023 Feb 8.
  J Metab Bariatr Surg. 2022.

  PMID: 36926672
  Free PMC article.

  Review.

• Symptomatic gallstones and HIV in black South African women: Changing trends of gallstone disease?

  Mewa Kinoo S, Nagiah S, Chuturgoon A, Singh B.

  Mewa Kinoo S, et al.
  South Afr J HIV Med. 2021 Mar 25;22(1):1208. doi: 10.4102/sajhivmed.v22i1.1208. eCollection 2021.
  South Afr J HIV Med. 2021.

  PMID: 33936792
  Free PMC article.

• Clinical Practice Recommendations for the Management of Obesity in the United Arab Emirates.

  Abusnana S, Fargaly M, Alfardan SH, Al Hammadi FH, Bashier A, Kaddaha G, McGowan B, Nawar R, Sadiya A.

  Abusnana S, et al.
  Obes Facts. 2018;11(5):413-428. doi: 10.1159/000491796. Epub 2018 Oct 30.
  Obes Facts. 2018.

  PMID: 30372696
  Free PMC article.

  Review.

• Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

  Fruh SM.

  Fruh SM.
  J Am Assoc Nurse Pract. 2017 Oct;29(S1):S3-S14. doi: 10.1002/2327-6924.12510.
  J Am Assoc Nurse Pract. 2017.

  PMID: 29024553
  Free PMC article.

  Review.

• Obesity and pancreatitis.

  Khatua B, El-Kurdi B, Singh VP.

  Khatua B, et al.
  Curr Opin Gastroenterol. 2017 Sep;33(5):374-382. doi: 10.1097/MOG.0000000000000386.
  Curr Opin Gastroenterol. 2017.

  PMID: 28719397
  Free PMC article.

  Review.

See all “Cited by” articles

Publication types

MeSH terms

Substances

Why Weight Loss Increases Gallstone Risk

As for everything in life, weight loss too has its pros and cons.  While the health benefits of weight loss are numerous and powerful, there is an increased risk of gallstone formation, particularly if the weight loss is fast.

Gallstones are very common, being present in 17% of women and 8% of men (most don’t know that they have them!).  Bile, which is the digestive juice made by the liver and stored in the gallbladder, is composed of bile acids, which are made by the liver from cholesterol.  Bile also contains cholesterol, phospholipids, proteins and electrolytes.  The bile is usually able to carry cholesterol produced by the liver out into the intestine in a liquid form, but if the cholesterol concentration gets too high, or the contraction of the gallbladder gets too sluggish, cholesterol crystals develop and gallstones form.

Obesity is a risk factor for gallstones for a number of reasons.  There is a larger pool of cholesterol moving around in the body, and the liver’s ability to convert cholesterol into bile acids is impaired (thus, more cholesterol relative to bile acids in the bile).   Gallbladder contractions are also more sluggish in obesity, which may be related to insulin resistance and resistance to a satiety (sense of fullness) hormone called leptin.  Diabetes, prediabetes, use of the birth control pill, and hormone replacement therapy are other risk factors for gallstone disease.  Genetics also play a part in gallstone risk, which is an area that we are just starting to learn about.

Within the first 4 months of moderate weight loss on a diet, the risk of gallstones is as high as 25% (though most of these will be without symptoms).  With faster and larger weight loss, the risk is higher: as many as 71% of patients will have gallstone formation by 1 year after bariatric (obesity) surgery.  About 40% of people developing gallstones after bariatric surgery will have symptoms; for those who don’t have symptoms, about half will disappear by 2 years after surgery.

Gallstones form during weight loss because cholesterol content of bile increases during weight loss, as fats are being moved out of fat tissue and being utilized or disposed of by the body.  If calorie intake is too low, bile acid production by the liver may drop as well.  Also, during rapid weight loss, the gallbladder contractions become more sluggish.

So, what are the take home messages here?  Again, remember that the health benefits of weight loss are great and numerous, and far outweigh the potential risk of gallstone formation.  That being said, losing weight at a reasonable rate (max 1-2 lb per week) helps to prevent the higher risk of gallstones that comes with too rapid a rate of weight loss.  For those who will be losing weight quickly with bariatric surgery, your surgeon may recommend that your gallbladder be removed at the time of surgery if you already have gallstones.  If not, a medication called URSO (ursodeoxycholic acid) may be recommended, which has been shown to reduce the risk of gallstone formation after gastric bypass surgery by 60%.

Follow me on twitter! @drsuepedersen

www.drsue.ca © 2015

Cholecystitis – Healthy Russia

June 13, 2012

What is the danger of pain in the right upper part of the abdomen that gets worse after eating? Learn about symptoms to watch out for.

Cholecystitis is inflammation of the gallbladder . This small pear-shaped organ is located on the lower surface of the liver on the right side of the abdomen. The gallbladder collects and secretes bile, which is involved in the digestion of fats, through a special duct into the duodenum.

If cholecystitis occurs suddenly, it is called sharp . If it develops for a long time – chronic .

What causes cholecystitis?

1. Approximately 95 percent of cases of cholecystitis are caused by gallstones formed by cholesterol, thickened mucus, and calcium and bilirubin compounds. These stones block the duct of the gallbladder – it overflows and becomes inflamed.

Lose weight wisely

Fasting and sudden weight loss lead to stagnation of bile in the ducts and can provoke the formation of insoluble gallstones.

2. Injuries of the gallbladder. Inflammation can cause a blow to the stomach – in the area of ​​\u200b\u200bthe liver. Cholecystitis can also be a consequence of surgical intervention.

3. Infection. If an infection gets into the bile, it can cause the gallbladder to become inflamed.

4. Tumor. The growth of a malignant or benign tumor can block the duct of the gallbladder. As a result of the accumulation of bile, inflammation develops.

Risk factors for cholecystitis

• Development of cholelithiasis in close relatives
• Type 1 and type 2 diabetes
• Elevated blood lipids
• Too rapid weight loss due to unbalanced diet
• Obesity
• Senior age
• Pregnancy

Main signs of cholecystitis

• Pain in the right upper abdomen
• Bloating
• Slight temperature increase
• Chills
• Sweating
• Decreased or absent appetite
• Nausea
• Vomiting

These symptoms are generally worse after eating especially fatty foods.

In the case of acute cholecystitis, pain in the right upper abdomen occurs suddenly, is very intense and does not go away on its own. It can also increase with deep breathing and give to the right shoulder and back.

Attention! The appearance of one or more of the symptoms listed above requires urgent medical attention.

As a rule, the formation of stones in the gallbladder requires surgical treatment . Without it, serious complications can develop – up to rupture of the gallbladder and peritonitis.

How to reduce the risk of cholecystitis?

Prevention of cholecystitis usually involves reducing the risk of developing gallstones:

1. Follow the diet, trying to stick to the usual time for breakfast, lunch and dinner. Do not skip meals and switch to fractional meals. It will prevent disruption of the gallbladder.

2. Avoid fatty foods. Frequent consumption of saturated fats leads to disruption of the gallbladder and the development of stones in it.

Have pity on the liver

An unhealthy lifestyle leads not only to the appearance of stones in the bile ducts, but also to the dysfunction of the liver itself. Remember, alcohol, smoking and the liver are not friends!

3. Be physically active – this can reduce the risk of developing gallstones. Practice at least five times a week, for at least 30 minutes every day.

4. Maintain a healthy body weight. The closer your weight is to your ideal body mass index, the lower your risk of developing cholecystitis.

5. If you have extra pounds and want to lose weight – reduce weight at a reasonable pace. Rapid weight loss increases the risk of developing gallstones. Remember that healthy weight loss does not exceed 0.5-1 kg per week .

Essential

Most often, cholecystitis is caused by the formation of stones in the gallbladder. To reduce your risk of gallbladder inflammation, eat right, stay physically active, and don’t try to lose weight too quickly.

Photo: open cage

To leave a comment – you must be an authorized user

Cholecystitis. Causes. Diagnostics. Treatment. | Health Clinic

What is cholecystitis

The most famous and at the same time quite a serious disease that occurs in the abdominal cavity is cholecystitis, under which they comprehend nothing more than an inflammatory process of the gallbladder. Today, the disease covers about 17% of the adult population and does not tend to decrease in these indicators in the future. This is due not only to an increase in the rates of diseases of the endocrine system, such as diabetes mellitus and obesity, but also to a modern, immobile way of life, as well as excessive consumption of foods saturated with animal fats.

This disease affects women more than men, which is associated with tolerated childbirth, pregnancy, as well as the use of oral contraception.

To date, there are several forms of leakage:

• Acute cholecystitis.
• Chronic stage of the disease.

Regardless of the form of the course, the disease can be calculous, with the formation of stones, as well as acalculous. Moreover, the first form is considered more common.

Symptoms of cholecystitis

Against the background of ailments of the gallbladder, the symptoms of cholecystitis are quite easily determined, among which the main ones can be distinguished:

• Nausea.
• Constant heaviness in the right side.
• An eructation of bitterness.
• Decreased appetite.
• The predominance of yellow in the shade of the face.
• Pain sensations of a dull nature, radiating to the shoulder blade.
• Digestive disorders.
• Rare occurrence of vomiting.

Causes of disease

In fact, it is quite difficult to name the causes of cholecystitis, because inflammatory processes in the gallbladder can occur for various reasons. However, the main ones are still:

• stone formation;
• genetic aggravated predisposition;
• dietary abuse;
• anomaly of the gallbladder;
• mental and emotional stress;
• external viral and parasitic infectious agents;
• modification of microflora;
• pregnancy or hormonal imbalance;
• rapid weight loss;
• sedentary lifestyle;
• food or other allergies;
• immune disorders;
• taking drugs that promote the formation of stones.

Diagnosis of cholecystitis

The best and timely option for determining the presence of the disease is an early study, during which it is possible to identify deviations in the chemical composition of bile, which allows you to avoid medicinal and conservative interventions, thanks to strict adherence to medical recommendations and a strict diet.

When symptoms appear, the diagnosis of cholecystitis includes modern and affordable methods for detecting the disease. Our doctors resort to bacteriological studies, examination of the cavity on ultrasound machines, as well as duodenal sounding or laparoscopy. Only by determining the ultra-precise biochemical composition of bile acids in the cavity of the gallbladder can a diagnosis be made with confidence, avoiding the formation of complications in the form of calculosis.

Treatment of cholecystitis

Depending on the severity, stage and form of cholecystitis, our specialists determine the practical impact. If an acute form of the disease is observed, then the treatment is accompanied by a stay in the hospital. Simple forms without complications, which are not accompanied by pain, can do without hospitalization of the patient.

If necessary, the specialist will decide on surgical or conservative treatment. With moderate severity of the disease, therapy is used, trying to exclude surgical intervention, influencing the inflammatory process by the following methods:

• food restrictions, strict diet;

• taking medications;
  ECLT or stone destruction by extracorporeal shock wave lithotripsy.

If drug therapy has not brought results, or the bladder does not function, acute or systematic exacerbations, a crisis form, biliary colic are observed, then the doctors are left with the surgical treatment of cholecystitis. Performing cholecystectomy, surgeons remove the affected bladder, eliminating the disease completely.

Consultation can be obtained by phone: +7(495) 961-27-67

Why are our gastroenterologists better than others?

• The knowledge and experience of the doctors of our clinic allow us to achieve amazing success in the treatment of gastroenterological diseases.

• The Health Clinic has the most modern diagnostic equipment that allows you to make an accurate diagnosis and start treatment.

• Location in the very center of Moscow, within walking distance from two metro stations.

• Attractive prices

• Convenient time to visit a doctor.