Monday, November 4, 2019

Gallstones Essay Example | Topics and Well Written Essays - 3000 words

Gallstones - Essay Example In general, gallstones are about two times more common in women than in men. Most study series show a prevalence of gall stones in women between the age of 20-55 years (5-20%) and after the age of 50 years, the prevalence for men is about half as that for women in a given age group (Sleisenger, 2002). The first degree relatives of patients with gall stones are 4.5 times more likely to develop the same condition as compared to age and gender matched controls (Sarin, 1995). High-risk populations include Pima Indians in Arizona, where 70% of women older than 25 years have gallstones. About 50 % of Scandinavians develop the condition by 50 years of age. Other high-risk populations comprise the American Indian groups in Alaska, Canada, Bolivia and Chile (Egbert, 1991). The populations at the lowest risk are those in Sub-Saharan Africa and Asia (Su CH, 1992) Obesity is a well-known risk factor and individuals with BMI > 45kg/w2 are at a seven-fold higher risk for the development of gallstones in comparison with controls (Stampfer MJ, 1992). Cholesterol hypersecretion into bile and increased cholesterol secretion have been implicated. Rapid weight loss contributes to gallstone disease. About 25% of obese patients on strict dietary restriction and 50% of patients who have gastric bypass develop gallstones, 6 months following the surgery (Shiffman ML et al., 1986.) Foetal parenteral nutrition and drugs like clofibrate, oral contraceptives, estrogens, progesterone, ceftriaxone and octreotide are causative agents. Pregnancy is a potentially lithogenic condition due to increased cholesterol secretion and supersaturation of bile, occurring due to increased estrogen levels (Lynn J, 1973). In many studies, fecundity has been implicated in the increased prevalence of gallstone (Tsimoyiannis, 1994 & Miquel JF, 1998.) According to their chemical composition, gallstones can be classified into cholesterol stones, mixed stones, and pigment stones. Cholesterol

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