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GALLSTONES
AVOID
Weight gain
Excessive alcohol
The gallbladder seems to serve not purpose other than to store and concentrate bile, a substance produced by the liver to digest fats in the small intestine. Removal of the organ appears to have no effect on digestion. Bile fluid contains high levels of cholesterol and the pigment bilirubin, both of which precipitate as crystals to form stones; these may be as fine as beach sand or as coarse as river gravel. Most gallstones are hardened cholesterol; the rest are made up of bilirubin plus calcium.Gallstones can develop in both sexes, but they are most common in overweight middle-aged women. They also tend to run in families. Women, especially those who have borne children are thought to be particularly vulnerable because of the high levels of blood cholesterol and bile that develop late in pregnancy and in the weeks following childbirth. It is believed, too, that the female hormones progesterone and estrogen, whether occurring naturally or taken in oral contraceptives, may play a role in gallstone formation. Crash weight-loss diets are believed to be another precipitating factor; many people appear to develop gallstones after a period of yo-yo dieting, with repeated cycles of weight loss and gain, or after a single dramatic weight loss.

Many people never know they have gallstones because they have no symptoms. For some, however, the presence of gallstones can cause pain in the upper right abdomen when the gallbladder contracts to release bile after a meal, and inflammation of the gallbladder that brings on sudden, severe pain extending to the back and under the right shoulder blade, with fever, chills and vomiting.
For frequent painful attacks, the usual treatment is the surgical removal of the gallbladder, called cholecystectomy; the procedure can be performed by conventional surgery or by laparoscopy, which involves only a tiny incision and brief hospital stay. Medications have been used with mixed success to dissolve gallstones, but the stones often recur if the person stops taking the drug. Another option is a procedure called lithotripsy, which uses shock waves to break up the gallstones.