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Gallstones

Gallstones are small stones mainly made of cholesterol that form in the gallbladder. In the vast majority of individuals, gallstones do not cause any symptoms. However, sometimes gallstones can become trapped in ducts, or irritate the gallbladder, and cause symptoms, such as:

  • A sudden intense pain in the abdomen
  • Nausea and vomiting
  • Jaundice.

The scale of the issue

Gallstones are very common. It is estimated that 6-22% of the population in Europe have gallstones1. However, 80% of individuals with gallstones will not suffer any symptoms linked to their presence, and the outlook for patients with gallbladder disease is extremely positive as the mortality rate is very low2.

Gallbladder disease

There are three main stages of gallbladder disease:

  • Asymptomatic gallstones: gallstones are present but do not cause any symptoms.
  • Uncomplicated gallstone disease: usually caused when gallstones block the bile duct. This can lead to episodes of abdominal pain that last several hours but occur infrequently.
  • Complicated (symptomatic) gallstones, or gallbladder disease: gallstones cause serious complications, e.g. inflammation of the gallbladder. Symptoms can include a high temperature, jaundice and constant abdominal pain.

The treatment for gallbladder disease is the removal of the gallbladder (cholecystectomy), though not everyone will require surgery if their symptoms are not frequent or severe2.

Coffee consumption and gallstones

  • Several studies3,4,5 show that habitual coffee consumption is associated with a reduced risk of developing gallbladder disease.
  • There is some evidence that coffee triggers the contraction of the gallbladder.
  • It appears likely that caffeine is largely responsible for the effect of coffee, since consumption of decaffeinated coffee is not linked to a reduced risk of developing gallbladder disease in all studies.
  • An increase in plasma cholecystokinin* levels, resulting in gallbladder contraction, has been reported after drinking both caffeinated and decaffeinated coffee. This would suggest coffee components other than caffeine may be responsible.
  • Coffee may have different effects depending on the stage of gallbladder disease progression. Increased gallbladder contraction may prevent small crystals becoming large gallstones in early disease, but if large gallstones are present, gallbladder contraction may cause pain.

*Cholecystokinin is a gastrointestinal hormone produced in the duodenum in response to the ingestion of fats and other food substances. It stimulates the release of bile from the gallbladder and digestive enzymes from the pancreas, facilitating the digestive process.

References
1 Aerts et al. (2003), The burden of gallstone disease in Europe. Aliment Pharmacol Ther 18(Suppl):349-353.
2 Everhart et al. (2009), Burden of digestive diseases in the United States. Gastroenterol 136(2):376-386.
3 Misciagna G. et al. (1996), Epidemiology of cholelithiasis in Southern Italy. Part II: risk factors. Eur J Gastroentero Hepatol, 8:585-593.
4 Leitzmann M.F.et al. (1999), A prospective study of coffee consumption and risk of symptomatic gallstone disease in men. JAMA, 281:2106-2112.
5 Leitzmann M.F. et al. (2002), Coffee intake is associated with lower risk of symptomatic gallstone disease in women. Gastroenterol, 123:1823-1830.

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