[Fat Bear Science] Gallstones are more common in the "F4" group, and if left untreated for a long time, there is a risk of cancer

F4 stands for Fat, Forty (over 40 years old), Fetation (pregnancy), and Female.

"If a woman of childbearing age often skips breakfast and is obese and doesn't like to exercise, then she has basically all the risk factors for gallstones."

Deng Hejun, director of the Department of Hepatobiliary and Pancreatic Tumors at Chongqing Cancer Hospital, said that in recent years, with the changes in people's lifestyles, the incidence of gallstones has shown a clear increasing trend, and is "favoring girls over boys."

Gallstones are potentially harmful to the human body. Therefore, once female friends discover gallstones during a physical examination, they should pay close attention or seek timely diagnosis and treatment under the guidance of a doctor to avoid turning gallstones into bile duct stones, gallstone pancreatitis, and gallbladder cancer.

Deng Hejun: Director of the Department of Hepatobiliary and Pancreatic Oncology, Chongqing Cancer Hospital/Affiliated Cancer Hospital of Chongqing University, Chief Physician, Master of Medicine, Leader of the Department of Hepatobiliary and Pancreatic Oncology, Chief Expert of Liver Cancer, Chongqing Cancer Hospital, Member of the Chinese Chapter of the International Hepatobiliary and Pancreatic Association, Member of the Pancreatic Cancer Committee of the Chinese Anti-Cancer Association, Member of the Hepatobiliary Committee of the Chongqing Medical Association. He has been engaged in clinical work in the Department of Hepatobiliary and Pancreatic Oncology for more than 30 years, and is good at laparoscopic and open surgery of the hepatobiliary, pancreatic and spleen, and has rich clinical experience in the diagnosis and treatment of liver cancer, pancreatic cancer, bile duct cancer and gallbladder cancer.

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Pregnancy is a high-risk period for gallstones

"The overall incidence of gallstones in Chongqing is around 17%, with the incidence in women as high as 20% and the incidence in men about 10%." Director Deng said, this shows that there are significantly more female gallstone patients than male patients.

The causes of gallstones are relatively complex. Currently, the high-risk factors recognized by the medical community mainly include high cholesterol, high-fat diet, female hormones, bile tract inflammation, abnormal bile metabolism, gallbladder polyps and genetic susceptibility genes, all of which can lead to a high incidence of gallstones.

For example, after a woman becomes pregnant, it will promote the formation of gallstones. This is because after a woman becomes pregnant, progesterone and estrogen change, which can cause the gallbladder's contraction function to decrease and promote the formation of gallstones. And the more pregnancies there are, the higher the incidence rate. For example, people who take oral contraceptives for a long time are twice as likely to develop gallstones as normal people. Women who are treated with estrogen drugs after menopause also have a significantly increased chance of developing gallstones. These may all be related to the effects of female hormones.

Skipping breakfast and lack of exercise are high-risk factors

Director Deng also pointed out that it is common for female friends to skip breakfast and drink water in order to diet, or to have irregular diets due to work pressure, or to have no time for exercise. However, if this continues for a long time, the contraction force of the gallbladder muscles will inevitably decrease, and bile emptying will be delayed, which can easily cause bile stasis and cholesterol crystallization, creating conditions for the formation of gallstones.

In addition, many female friends usually eat high-fat, high-sugar, and high-cholesterol snacks, which cause obesity. Obesity is another important cause of gallstones. Studies have shown that the incidence of gallstones is 5 times higher in people whose weight exceeds the normal standard by more than 15%, especially obese women over 40 years old, who are more susceptible to it.

"Therefore, female friends should eat properly and maintain a good lifestyle whether during pregnancy or in normal times. This is an effective way to prevent gallstones and gallbladder cancer," said Director Deng.

Whether gallstones should be treated depends on whether there are symptoms

60-80% of patients with clinical gallstones have no symptoms, and they are basically discovered accidentally during physical examinations. The main symptoms of gallstones can be manifested as dull pain and distension in the right upper abdomen; dull pain in the right lower back; severe biliary colic during acute attacks of gallstones, which may be caused by small stones stuck in the gallbladder duct; if acute cholecystitis occurs, it may manifest as fever, nausea, vomiting, etc. Therefore, once such symptoms appear, they should be taken seriously.

Director Deng said that the main components of gallstones are cholesterol calcium salt and bile pigment calcium salt. Long-term presence in the body can cause acute and chronic cholecystitis; small stones less than 5 mm can easily fall into the common bile duct, causing bile duct obstruction and pancreatitis; over time, it can also easily cause gallbladder polyps and gallbladder cancer.

So, what should we do? Director Deng said that this needs to be treated according to different situations. If there are no symptoms, if there is no obvious thickening of the gallbladder wall, the gallbladder contraction function is normal, and the cystic duct is unobstructed, regular color Doppler ultrasound examinations can be performed to observe the changes in the gallbladder wall and whether there is a tendency to cancer. If there are symptoms, such as frequent stomach pain and bloating, or abdominal distension and pain after eating greasy food, early surgery is recommended. In addition, even if there are no symptoms, but the gallbladder wall has irregular thickening, the history of gallstones is more than 3 years, and the stone diameter is greater than 3 cm, early surgery is also recommended due to the high risk of cancer.

Follow your doctor's advice on which treatment to use

There are three main treatments for gallstones: open cholecystectomy, laparoscopic cholecystectomy, and gallbladder-preserving and lithotripsy. However, studies in recent years have shown that cholecystectomy can lead to an increased incidence of colon cancer, and can also cause symptoms of indigestion such as bile reflux gastritis, and increased frequency of bowel movements after postoperative satiety or a high-fat diet. Therefore, many patients currently want to choose gallbladder-preserving and lithotripsy. "Whether or not gallbladder-preserving surgery is suitable, it is recommended to listen to the doctor's advice and decide based on specific indications," Director Deng suggested.

In addition, some patients think that the stones are small, so they choose to take drugs such as stone removal and bile promotion, or use extracorporeal lithotripsy. He pointed out that these two methods are not recommended. Because the small stones that are removed and fall into the common bile duct can damage the hepatopancreatic ampulla sphincter at the end of the common bile duct. Repeatedly, this will cause stenosis of the end of the common bile duct or stone incarceration, which may cause biliary colic at the mildest and secondary bile duct infection and biliary pancreatitis at the worst. Therefore, once gallstones are found, it is best to treat them under the guidance of a doctor.

Although gallstones often plague F4, adjusting lifestyle habits can still play a positive role in prevention:

Control your weight and eat a healthy diet

Obesity makes us more susceptible to gallstones, so we should avoid high-fat, high-calorie diets and maintain a good weight. Eating more fiber-rich foods can improve cholesterol metabolism and help prevent the formation of stones.

Eat breakfast to lose weight

Eating regularly (three meals a day) can prevent the formation of stones.

Vegetarians should take lecithin supplements

Normally, cholesterol, bile salts and lecithin are mixed in a certain ratio and suspended in bile in the form of micro-particles. When this ratio is disrupted, gallstones are easily formed. Some vegetarians do not take enough lecithin, and the excessive fiber in vegetarian food hinders the reabsorption of bile acid, which reduces the bile salt concentration in bile. They should supplement lecithin appropriately.

Scheduled physical examination

Ultrasound is the most effective and convenient method for gallstones. A physical examination once a year can detect gallstones or the state of gallstones in time; what is cholesterol crystallization and bile stasis, and give yourself a reminder to pay attention to adjusting your diet and lifestyle. If stones appear, treat or observe according to the situation.

Text/ Fat Bear Picture/ Online Review/ Deng Hejun

Original article, please do not reprint without authorization

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