Gallstones - the reason to leave fat foodAbraham Eisenstein, M.D. ▼ |
Gallstones form when liquid called bile stored in the gallbladder hardens into pieces of stone-like material. Bile is made in the liver and used to help the body digest fats. The gallbladder can develop just one large stone, hundreds of tiny stones, or almost any other combination. But in general, there are two types of gallstones: cholesterol stones and pigment stones.
What are risk factors? The first place belongs to obesity. This is a major risk factor for gallstones, especially in women. Ethnicity is the second important factor: in the South America 70 percent of women have gallstones by age 30 while in the other parts of the world that number is significantly smaller. Gender is also important because women are twice as likely to develop gallstones as men. People with diabetes, people on the diet for rapid weight loss and people that are fasting often are also in the high-risk group.
Symptoms of gallstones are called "attack" because they occur suddenly. Gallstone attacks often happen after fatty meals, and they may occur during the night. A typical attack causes strong pain in the upper abdomen that lasts from 30 minutes to several hours. It can also cause pain in the back between the shoulder blades, pain under the right shoulder, while some patients can suffer from nausea or vomiting.
If you feel such pain and in addition to that you are sweating, have chills, slightly increased fever, if your skin or whites of the eyes are yellow - see the doctor immediately.
The most common way to treat gallstones is a surgery. In 95 percent of cases it will be done by laparoscopic cholecystectomy, in other words there's no open surgery and the patient stays one night in the hospital, followed by several days of restricted activity at home.
However, if the stones are big an open surgery is needed but that's not a big problem either: it results in about five days in the hospital and several weeks at home to recover. Nonsurgical approaches are also used (the patient is given drugs or he is treated with shock waves), but after nonsurgical treatment gallstones will return in 50 percent of patients.
In the acute phase, when you have gallstones but it's not the time for the surgery yet, the diet is light with a low share of fat mainly consisting of carbohydrates and less fibres. When symptoms settle down, proteins are added to expand the menu. You should take into account how the food is prepared - you need to separate all visible fat from meat and cook it rather than fry it.
Eat more often, but not large portions. After a meal lay down for at least a half an hour, and put a warm compress on the gall bladder area. In the case of intense abdominal pain you should limit the intake of food, drink sweat tea, fruit juices and skimmed milk.
Drink milk with up to 1% milk fat and milk products with a low share of fat. Replace red meat with white meat (chicken, turkey) and fish. Do not eat fried food and too many eggs and if you do, remove yolk. Eat fruit, vegetables (avoid bean, green salad and cabbage), drink juice and avoid refined sugar and sweets, caffeine and chocolate. Avoid sudden changes in body mass.
It is interesting that many people with gallstones have no symptoms at all. We call them asymptomatic patients, their gallstones don't cause any trouble and those patients don't need treatment. Another interesting fact is that we don't need gallbladder at all. If it is damaged and removed, bile will simply flow from the liver into the small intestine, instead of being stored in the gallbladder. And if you don't have gallbladder you even don't have to change your regular diet. ■